Carolina Wellness Clinic, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4470 Issued in SC

Legal business name

CAROLINA WELLNESS CLINIC, LLC

Practice address

958 E Main St
Suite B
Spartanburg, SC 29302-2148

Phone

(864) 641-6632

NPI assigned

Aug 4, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Damien Bailey, NPNPI 1043518087

Title

Owner

Phone

(864) 641-6632

Specialties & licenses 1

Addresses

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

• Damien Bailey, APRN

  • Family Nurse Practitioner
  • New York, NY
  • NPI 1043518087

  Family

  NPD (past) Authorized official

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470268800000",
    "number": "1992259139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 COBBLESTONE XING",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293414436",
            "telephone_number": "803-447-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 E MAIN ST",
            "address_2": "SUITE B",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022148",
            "telephone_number": "864-641-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DAMIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-641-6632",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "4470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Smiles, LLC
• Carolina Sunrise Home Health Care, LLC
• Carolina Surgical Specialists LLC
• Carolina Vision Associates, LLC
• Carolina Vision Associates, LLC
• Carolina-in-Home-Aide,LLC
• Carolinas Center for Advanced Management of Pain, LLC
• Carolinas Pathology Group, PA
• Kimberly M Carpenter, CRNA
• Tia Carpenter, DNAP

• All providers in Spartanburg, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.