NPIMap

Organization Active NPI

St. James Health and Wellness Inc.

  • Federally Qualified Health Center (FQHC)
  • Georgetown, SC
National Provider Identifier
1962250258
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST. JAMES HEALTH AND WELLNESS INC.
Practice address
4145 Powell Rd
Georgetown, SC 29440-8136
Phone
(843) 990-7993
Fax
(843) 887-3817
NPI assigned
May 10, 2024
Organization subpart
Yes
Parent organization
ST. JAMES HEALTH AND WELLNESS INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Sandra D Gilliard
Title
Ceo
Phone
(843) 990-7993

Other NPIs on the same Medicare enrollment 4

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

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2316110St James Health and Wellness Inc4145 Powell Rd, Georgetown, SC 29440Certificate of waiverDec 26, 2026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050810000151 SC Part B Supplier - Clinic/Group Practice 1658280334 Receives reassigned benefits from 22 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Georgetown, SC; McClellanville, SC

National Provider Directory

National Provider Directory
Tax ID family
St James-Santee Family Heal9 organizations share this tax ID, including this one
Part of
St James-Santee Family Heal

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

411 E Main St
Andrews, SC 29510
Phone (843) 264-1223

422 N Fraser St
Georgetown, SC 29440
Phone (843) 436-1333

8189 Choppee Rd
Georgetown, SC 29440
Phone (843) 259-2712

1189 Tibwin Rd
Mc Clellanville, SC 29458
Phone (843) 887-3929

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

4145 Powell Rd
Georgetown, SC 29440-8136

Mailing address

PO Box 608
MC Clellanville, SC 29458-0608
Phone (843) 990-7993

Other names 1

NPPES NPI Registry
  • St. James-Santee Family Health Center, Inc. Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 10, 2024.

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1962250258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "MC CLELLANVILLE",
            "state": "SC",
            "postal_code": "294580608",
            "telephone_number": "843-990-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4145 POWELL RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294408136",
            "telephone_number": "843-990-7993",
            "fax_number": "843-887-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES HEALTH AND WELLNESS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JAMES HEALTH AND WELLNESS INC.",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "GILLIARD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-990-7993"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. James-Santee Family Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.