NPIMap

Organization Active NPI

Edisto Regional Health Services Inc

Doing business as RMC Primary Care Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
National Provider Identifier
1922756352
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC
Doing business as
RMC Primary Care Bowman
Practice address
106 Causeway Drive
Bowman, SC 29018-8404
Phone
(803) 395-4497
Fax
(803) 395-2237
NPI assigned
Mar 15, 2022
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christal Leann Fulmer
Title
Revenue Integrity Manager
Phone
(803) 395-4248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

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 1

  • RMC Primary Care Bowman Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

Locations

110 Cswy CT
Bowman, SC 29018
Phone (803) 395-3025

5073 Carolina Hwy
Denmark, SC 29042
Phone (803) 245-5144

1170 Boulevard St
Ste A
Orangeburg, SC 29115
Phone (803) 533-0042

111 John Lawson Ave
Santee, SC 29142
Phone (803) 395-2070

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Mar 1, 2023 Change of OwnershipThis provider was the seller Musc Health Primary Care BowmanCCN 873810, SC, NPI 1225735772

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1922756352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4497",
            "fax_number": "803-395-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CAUSEWAY DRIVE",
            "city": "BOWMAN",
            "state": "SC",
            "postal_code": "290188404",
            "telephone_number": "803-395-4497",
            "fax_number": "803-395-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO REGIONAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "CHRISTAL",
        "authorized_official_middle_name": "LEANN",
        "authorized_official_title_or_position": "REVENUE INTEGRITY MANAGER",
        "authorized_official_telephone_number": "803-395-4248"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RMC Primary Care Bowman",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RMC Primary Care Bowman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowman, SC

Sources for this page

Verify at the official NPI Registry.