NPIMap

Organization Active NPI

Fetter Health Care Network, Inc

  • Federally Qualified Health Center (FQHC)
  • Walterboro, SC
National Provider Identifier
1962737601
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FETTER HEALTH CARE NETWORK, INC
Practice address
302 Medical Park Dr
Suite 111
Walterboro, SC 29488-5747
Phone
(843) 549-6853
Fax
(843) 549-7961
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Aretha Jones
Title
Executive Director
Phone
(843) 722-4112

Specialties & licenses 1

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

Addresses

Primary practice location

302 Medical Park Dr
Suite 111
Walterboro, SC 29488-5747

Mailing address

51 Nassau St
Charleston, SC 29403-5513
Phone (843) 722-4112

Other identifiers 1

IdentifierTypeStateIssuer
FQC076MedicaidSC

Other names 1

  • Fetter Health Care Network-Walterboro Site Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fetter Health Care Network Inc38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1962737601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 NASSAU ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035513",
            "telephone_number": "843-722-4112",
            "fax_number": "843-577-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MEDICAL PARK DR",
            "address_2": "SUITE 111",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885747",
            "telephone_number": "843-549-6853",
            "fax_number": "843-549-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FETTER HEALTH CARE NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ARETHA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-722-4112"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC076",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fetter Health Care Network-Walterboro Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.