NPIMap

Organization Active NPI

Carolina Family Care, Inc

  • Clinical Medical Laboratory
  • Mt Pleasant, SC
National Provider Identifier
1992832869
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
20-17508 Issued in SC
Legal business name
CAROLINA FAMILY CARE, INC
Practice address
1600 Midtown Ave
Mt Pleasant, SC 29464-3771
Phone
(843) 876-8110
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Karyn Rae
Title
Manager
Phone
(843) 876-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 20-17508 SC Primary

Addresses

Primary practice location

1600 Midtown Ave
Mt Pleasant, SC 29464-3771

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 573-1517

Other identifiers 1

IdentifierTypeStateIssuer
L00125MedicaidSC

Other names 1

  • MUSC Physicians PCP Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000509 SC Part B Supplier - Independent Clinical Laboratory 4587557731 Practice locations: Mount Pleasant, SC; North Charleston, SC

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Carolina Family Care Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

29 Leinbach Dr
Ste B
Charleston, SC 29407

864 Island Park Dr
Ste 101
Daniel Island, SC 29492
Phone (843) 792-4500

1600 Midtown Ave
Fl 1
Mount Pleasant, SC 29464

2154 N Center St
Ste 105A
North Charleston, SC 29406
Phone (843) 876-8191

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1992832869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-573-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MIDTOWN AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643771",
            "telephone_number": "843-876-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": "20-17508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00125",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSC Physicians PCP Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUSC Physicians PCP Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.