Edisto Regional Health Services Inc
Organization Active NPI Rural Health Clinic/Center · Bowman, SC
NPI 1922756352 · NPPES record last updated Oct 20, 2022
Key facts
- NPI
- 1922756352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- EDISTO REGIONAL HEALTH SERVICES INC
- Practice address
- 106 Causeway Drive
Bowman, SC 29018-8404 - Phone
- (803) 395-4497
- Fax
- (803) 395-2237
- NPI assigned
- Mar 15, 2022
- Organization subpart
- No
Authorized official
- Name
- Christal Leann Fulmer
- Title
- Revenue Integrity Manager
- Phone
- (803) 395-4248
Other NPIs on the same Medicare enrollment 17
Change of ownership 1
Practitioners 41
-
William Leroy Baly, M.D.
-
William N Braswell, M.D.
-
Erin Suzanne Castellano, A.P.R.N
-
Cameo Green Coleman, DNP, APRN, FNP-C
-
Rachel Danford, DNP,APRN,NP-C,FNP-BC
-
Brittney Nichole Frazier, FNP-C
-
Melanie Sheppard Hall, PHYSICIAN ASSISTANT
-
Angela Hampton, PA-C
-
Conita L Hill, PA
-
Thomas Hilliard, M.D.
-
Tara Hook, M.D.
-
Alexander Hovey, PA-C
-
Karen Jackson, APRN
-
Brian W Kendall, MD
-
Melanie Kittrell, CNM
-
Yongxin Li, MD
-
William E Oquinn, M.D.
-
Elzbieta Ostoja, MSN, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Mar 1, 2023 | Change of Ownership |
Musc Health Primary Care Bowman |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040810000307 | SC | Part B Supplier - Clinic/Group Practice | 4981693447 |
Receives reassigned benefits from 41 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bowman, SC; Bamberg, SC; Santee, SC; Saint Matthews, SC; Orangeburg, SC; Holly Hill, SC; Branchville, SC |
National Provider Directory
Locations
110 Cswy CT
Bowman, SC 29018
Phone (803) 395-3025
1619 Carolina Ave
Orangeburg, SC 29115
Phone (803) 531-7474
1750 Village Park Dr
Orangeburg, SC 29118
Phone (803) 395-4160
1727 Village Park Dr
Orangeburg, SC 29118
Phone (803) 531-2722
1170 Boulevard St
Ste A
Orangeburg, SC 29115
Phone (803) 533-0042
651A Harry C Raysor Dr
St Matthews, SC 29135
Phone (803) 395-3737
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
106 Causeway Drive
Bowman, SC 29018-8404
Mailing address
PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4497
Other names
- RMC Primary Care Bowman
Other providers in Bowman, SC
- Carolyn W. Boland
- Randy B Boland
- Branchville Rescue Squad
- Community Transport Services, LLC
- Pamela L Crisp
- Essential Behavior Counseling Services LLC
- Meredith Taylor Felder
- Mynita S. Harrison
- Victoria Jackson
- Eric D Keitt
All providers in Bowman, SC · Rural Health Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.