NPIMap

Organization Active NPI

Carolina Health Centers, Inc.

Doing business as The Children's Center

  • Pediatrics Physician
  • Greenwood, SC
National Provider Identifier
1972636025
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CAROLINA HEALTH CENTERS, INC.
Doing business as
The Children's Center
Practice address
113 Liner Dr
Greenwood, SC 29646-2311
Phone
(864) 941-8170
Fax
(864) 388-1718
NPI assigned
Mar 14, 2007
Last updated
Jun 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Mrs. Lisa Y Gilmer
Title
Practice Administrator
Phone
(864) 941-8121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

113 Liner Dr
Greenwood, SC 29646-2311

Mailing address

113 Liner Dr
Greenwood, SC 29646-2311
Phone (864) 941-8170

Other identifiers 2

IdentifierTypeStateIssuer
FQC051MedicaidSC
GP1632MedicaidSC

Other names 1

  • The Children's Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130517000483 SC Part A Provider - Federally Qualified Health Center (FQHC) 5496707804 Practice locations: Greenwood, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972636025. Details of each certification follow.

Federally qualified health center certification: CCN 421989

Legal name
CAROLINA HEALTH CENTERS INC
Doing business as
THE CHILDREN'S CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 23, 2013
Last certification
May 23, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 27, 1977 in SC
Enrollment address
113 Liner Drive
Greenwood, SC 29646-2311

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Carolina Health Centers Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

23265 Highway 76 E
Clinton, SC 29325
Phone (864) 393-1020

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christopher Scott Clem Individual Corporate OfficerCfo Jun 16, 2025
W-2 Managing EmployeeCfo Jun 16, 2025
Mary Stackhouse Individual Corporate DirectorBoard Member Mar 26, 1998
Abby Banks Individual Corporate DirectorBoard Member Mar 27, 2017
Kimberly Kapetanakos Individual Corporate DirectorBoard Member Mar 27, 2017
Malcolm O'Neal Individual Corporate DirectorBoard Member Sep 29, 2014
Miriam Ferguson Individual Corporate OfficerCeo Jul 14, 2025 100%
Mario Luna Individual Corporate DirectorBoard Member Sep 29, 2014
Gail D Ferguson Individual Corporate DirectorBoard Member Mar 3, 1987
John Britt Individual Corporate OfficerChairman of Board Mar 25, 1985
Corporate DirectorChairman of Board Mar 25, 1985
Gregory Bullard Individual Corporate OfficerVice Chairman, Finance Committee Jun 24, 1985
Corporate DirectorVice Chairman, Finance Committee Jun 24, 1985
Deborah Natvig Individual Corporate DirectorBoard Member Feb 22, 2010
Paul Grogan Individual Corporate OfficerChief Financial Officer Aug 6, 2012

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1972636025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462311",
            "telephone_number": "864-941-8170",
            "fax_number": "864-388-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462311",
            "telephone_number": "864-941-8170",
            "fax_number": "864-388-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "GILMER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-941-8121",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC051",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1632",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Children's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.