Little River Medical Center Inc - Medicare Mental Health Clinic in Little River, SC

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Little River Medical Center Inc is a medicare enrolled mental health clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Little River, South Carolina. The current practice location for Little River Medical Center Inc is 4303 Live Oak Dr, Little River, South Carolina. For appointments, you can reach them via phone at (843) 663-8000. The mailing address for Little River Medical Center Inc is Po Box 547, Little River, South Carolina and phone number is (843) 663-8000.

Little River Medical Center Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1629021076. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (843) 663-8000.

Contact Information

Little River Medical Center Inc
4303 Live Oak Dr
Little River
SC 29566-9138
(843) 663-8000
(843) 280-2455

Map and Direction


Mental Health Clinic Profile

Full NameLittle River Medical Center Inc
SpecialityClinic/Center
Location4303 Live Oak Dr, Little River, South Carolina
Authorized Official Name and PositionPamela R Davis (CEO)
Authorized Official Contact8436638001
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Little River Medical Center Inc
Po Box 547
Little River
SC 29566-0547

Ph: (843) 663-8000		Little River Medical Center Inc
4303 Live Oak Dr
Little River
SC 29566-9138

Ph: (843) 663-8000

NPI Details:

NPI Number1629021076
Provider Enumeration Date05/18/2006
Last Update Date05/21/2014

Medicare PECOS Information:

Medicare PECOS PAC ID2961309315
Medicare Enrollment IDO20031215000742

Medical Identifiers

Medical identifiers for Little River Medical Center Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629021076NPI-NPPES
FQC024MedicaidSC
ZA9656MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical (South Carolina)Secondary
122300000XDentist (South Carolina)Secondary
163WD0400XRegistered Nurse - Diabetes Educator (South Carolina)Secondary
183500000XPharmacist (South Carolina)Secondary
207Q00000XFamily Medicine (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary
363LF0000XNurse Practitioner - Family (South Carolina)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Little River Medical Center Inc acts as a billing entity for following providers:
Provider NameLuis D Insignares
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154374510
PECOS PAC ID: 1355249434
Enrollment ID: I20031229000165
Provider NameWilliam J Oconnor
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174576409
PECOS PAC ID: 2567363484
Enrollment ID: I20040115000047
Provider NameForrest Pommerenke
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952331662
PECOS PAC ID: 4880587534
Enrollment ID: I20040205000821
Provider NameDonald W Tice
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154380483
PECOS PAC ID: 6901700343
Enrollment ID: I20040217000480
Provider NamePatsy G Alexander
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1609032630
PECOS PAC ID: 2365401700
Enrollment ID: I20041011000056
Provider NameSuzanne L Schwab
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1699786749
PECOS PAC ID: 2769406420
Enrollment ID: I20060120000331
Provider NameDean Moesch
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1508819970
PECOS PAC ID: 6709873185
Enrollment ID: I20060926000047
Provider NameAnand P Lalaji
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1649245747
PECOS PAC ID: 7416928734
Enrollment ID: I20080408000870
Provider NameTejal Lalaji
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1225003320
PECOS PAC ID: 3577526524
Enrollment ID: I20080408000881
Provider NameChristine M Mcginley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1558314914
PECOS PAC ID: 2769453224
Enrollment ID: I20080522000394
Provider NameTina M Doud Kearns
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134199235
PECOS PAC ID: 5890745046
Enrollment ID: I20080611000880
Provider NameLynn M Manfred
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1346230661
PECOS PAC ID: 0345282232
Enrollment ID: I20080723000001
Provider NameRomeo Nillas
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922055722
PECOS PAC ID: 3678514056
Enrollment ID: I20090629000165
Provider NameRobert Jason Kellett
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1134159171
PECOS PAC ID: 3476595323
Enrollment ID: I20090811000098
Provider NameWalter E. Smith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326197864
PECOS PAC ID: 1254478084
Enrollment ID: I20091027000311
Provider NameLinda S Buster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932327178
PECOS PAC ID: 7719010693
Enrollment ID: I20100728001127
Provider NamePaul Cohen
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1194778423
PECOS PAC ID: 3476687427
Enrollment ID: I20100813000026
Provider NameMary Kaye Favaro
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1043326036
PECOS PAC ID: 1052328580
Enrollment ID: I20100917000355
Provider NameJennifer B Haynes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235304023
PECOS PAC ID: 3072692466
Enrollment ID: I20110316000389
Provider NameJose J Hernandez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1255561627
PECOS PAC ID: 0345428025
Enrollment ID: I20110628000595
Provider NameThomas Frederic Garland
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700837853
PECOS PAC ID: 2264535731
Enrollment ID: I20111020000105
Provider NameJohn D Hyatt
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1184696346
PECOS PAC ID: 0648465682
Enrollment ID: I20120731000374
Provider NameBeverly Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467703157
PECOS PAC ID: 8022262609
Enrollment ID: I20130206000629
Provider NameDonna M Smyth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033551890
PECOS PAC ID: 8921242868
Enrollment ID: I20140508001382
Provider NameRaymond A Reiser
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1700107240
PECOS PAC ID: 7618196528
Enrollment ID: I20140908001780
Provider NameMarwan S Al Aswad
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1689945651
PECOS PAC ID: 0840412433
Enrollment ID: I20141114002029
Provider NameDeborah D Moyer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740598432
PECOS PAC ID: 3173706835
Enrollment ID: I20141120002306
Provider NameOrlando R Valdez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1912945239
PECOS PAC ID: 5496650038
Enrollment ID: I20150330000994
Provider NameBrandy P P Van Heyde
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760813190
PECOS PAC ID: 4486972700
Enrollment ID: I20150417000846
Provider NameCharlotte Wiltshire
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1063804284
PECOS PAC ID: 1658690078
Enrollment ID: I20150507000569
Provider NameLaura Mary Norton
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1861828170
PECOS PAC ID: 3173830536
Enrollment ID: I20150916003454
Provider NameKarla Z Robinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538302716
PECOS PAC ID: 1658402045
Enrollment ID: I20151109000741
Provider NameJodie Lea Webb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578954137
PECOS PAC ID: 8426368952
Enrollment ID: I20151112000756
Provider NameBernice F Lim
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326303538
PECOS PAC ID: 4688814825
Enrollment ID: I20151208001355
Provider NameShauna T Walters
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1518226513
PECOS PAC ID: 2668773706
Enrollment ID: I20151215002273
Provider NameJanice M Moore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730552837
PECOS PAC ID: 7517264435
Enrollment ID: I20160321001294
Provider NameTricia M Payne
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1356740351
PECOS PAC ID: 1355631029
Enrollment ID: I20160608001790
Provider NameAamer Farooki
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1316941859
PECOS PAC ID: 5698768539
Enrollment ID: I20160620002362
Provider NameRegina R Evans
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1134113871
PECOS PAC ID: 8224091954
Enrollment ID: I20160629000636
Provider NameViki Lambertus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265746002
PECOS PAC ID: 5799809935
Enrollment ID: I20160708001695
Provider NameChristine L Gordon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477939437
PECOS PAC ID: 1355413550
Enrollment ID: I20160729002169
Provider NameTravis T Henderson
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1679539381
PECOS PAC ID: 3870514490
Enrollment ID: I20160817001289
Provider NameJohn B Feole
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1801817408
PECOS PAC ID: 5597784538
Enrollment ID: I20160824002239
Provider NameShannon M Shields
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598118358
PECOS PAC ID: 5799064291
Enrollment ID: I20161123001469
Provider NameEdward Chaum
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1023075868
PECOS PAC ID: 6406898493
Enrollment ID: I20161212000784
Provider NameNaomi Jean Ferguson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699217653
PECOS PAC ID: 1456635028
Enrollment ID: I20170227000575
Provider NameDan M Kass
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1215904172
PECOS PAC ID: 9739210048
Enrollment ID: I20170612000311
Provider NameDawn M Coffin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346641131
PECOS PAC ID: 2365754520
Enrollment ID: I20170822000101
Provider NameSarah J Prinzi
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1932442886
PECOS PAC ID: 5991014615
Enrollment ID: I20171113000874
Provider NameChris Rizzo
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1811309644
PECOS PAC ID: 6204194814
Enrollment ID: I20180102002529
Provider NameRochelle Davis
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821348970
PECOS PAC ID: 2860642790
Enrollment ID: I20180213000442
Provider NameMaribeth Reid
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679088793
PECOS PAC ID: 9537429535
Enrollment ID: I20180213001885
Provider NameJustin Pham
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1821040866
PECOS PAC ID: 0042104754
Enrollment ID: I20180410002470
Provider NameRachel A Gasque
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619481397
PECOS PAC ID: 7315201803
Enrollment ID: I20180509001585
Provider NamePeggy Bourguillon
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1073922753
PECOS PAC ID: 3971807157
Enrollment ID: I20180523002308
Provider NameEunice Luz Guzman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1043508708
PECOS PAC ID: 0244540979
Enrollment ID: I20180629002108
Provider NameLeslie Fahy Mclamb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528554532
PECOS PAC ID: 0143578823
Enrollment ID: I20180813002423
Provider NameMeredith Michelle Lukowski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568949352
PECOS PAC ID: 4486905460
Enrollment ID: I20181002000988
Provider NameRaleigh Rumley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1871971168
PECOS PAC ID: 4789936006
Enrollment ID: I20181015000409
Provider NameAngela D Woods
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225529555
PECOS PAC ID: 3476897927
Enrollment ID: I20181210003118
Provider NameChristina F Tolbert
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1417396219
PECOS PAC ID: 7214256171
Enrollment ID: I20181221000001
Provider NameLaura Taylor
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1104894096
PECOS PAC ID: 3375626518
Enrollment ID: I20190122000257
Provider NameCrystal D Bush
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1265532527
PECOS PAC ID: 1850426537
Enrollment ID: I20190521000032
Provider NameHayley B Guilkey
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1255718060
PECOS PAC ID: 7517291032
Enrollment ID: I20190702002968
Provider NameAndrew Rutledge Alkis
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1568728327
PECOS PAC ID: 0345479119
Enrollment ID: I20190807001511
Provider NameKevin A Kearney
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1578698775
PECOS PAC ID: 0648377655
Enrollment ID: I20191007003581
Provider NameJerry A Camisa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215585567
PECOS PAC ID: 0547692501
Enrollment ID: I20191112002795
Provider NameFarah Brown
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1871595736
PECOS PAC ID: 5294784856
Enrollment ID: I20191230000332
Provider NameJessica L Ionno
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1053514612
PECOS PAC ID: 0345313110
Enrollment ID: I20200107003501
Provider NameLyn-marie Kuball
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922632702
PECOS PAC ID: 0042649824
Enrollment ID: I20200330002033
Provider NameAutumn R Painter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346610086
PECOS PAC ID: 6901104181
Enrollment ID: I20200416001789
Provider NameKaryn D Asher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952780447
PECOS PAC ID: 1052732211
Enrollment ID: I20200527000481
Provider NameLara Wear Moody
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1225290737
PECOS PAC ID: 2567601610
Enrollment ID: I20200714002985
Provider NameErin E Hayes
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1891038212
PECOS PAC ID: 6901223056
Enrollment ID: I20200903001151
Provider NameMary Elizabeth Stoermann
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1184003717
PECOS PAC ID: 9537479258
Enrollment ID: I20201002001197
Provider NameElliott Jay Wagner
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1558312579
PECOS PAC ID: 7416856745
Enrollment ID: I20201014002530
Provider NameLindsey R Nelson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1043749104
PECOS PAC ID: 2062823990
Enrollment ID: I20201127000150
Provider NameMarcus Carty
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952755696
PECOS PAC ID: 8426488925
Enrollment ID: I20210107002001
Provider NameStewart Gilbert
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1487636445
PECOS PAC ID: 7012981285
Enrollment ID: I20210121001348
Provider NameDawn Behr-ventura
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1518934629
PECOS PAC ID: 7719993351
Enrollment ID: I20210121001382
Provider NameDennis Burton
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1043298417
PECOS PAC ID: 7416857388
Enrollment ID: I20210129001257
Provider NameKelly L Mccloskey
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1295126035
PECOS PAC ID: 1052678265
Enrollment ID: I20210309001645
Provider NameNicole Maria Bixler
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1578077715
PECOS PAC ID: 4880092147
Enrollment ID: I20211018001959
Provider NameKimberly Oxley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1073572103
PECOS PAC ID: 1759308224
Enrollment ID: I20211027002087
Provider NameSharon A Neubauer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1447908728
PECOS PAC ID: 5597152652
Enrollment ID: I20220420002096
Provider NameDonna Roberts Suter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518602051
PECOS PAC ID: 4688053200
Enrollment ID: I20220628000702
Provider NameLynda Myhre Stiles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386609030
PECOS PAC ID: 9638396427
Enrollment ID: I20220706001775
Provider NameWendy Gayle Mote
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811374820
PECOS PAC ID: 1153635990
Enrollment ID: I20220719002026
Provider NameEllen Caughman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265044267
PECOS PAC ID: 6204218795
Enrollment ID: I20220730000446
Provider NameAmanda Dorsey Cutshaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669043923
PECOS PAC ID: 4082019534
Enrollment ID: I20220804000234
Provider NameTravis James Miner
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1760916449
PECOS PAC ID: 3173957446
Enrollment ID: I20220822000216
Provider NameHeather Richardson
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1750591004
PECOS PAC ID: 3173660115
Enrollment ID: I20230316002203
Provider NameSydney Huggins
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1467080531
PECOS PAC ID: 4587086541
Enrollment ID: I20230927000831
Provider NameChristian Gilbert
Provider TypePractitioner - Addiction Medicine
Provider IdentifiersNPI Number: 1750348421
PECOS PAC ID: 2264336775
Enrollment ID: I20231018000846
Provider NameJosephette Melinda Dotson
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1902426356
PECOS PAC ID: 9931541984
Enrollment ID: I20240522003755

Reviews and Comments

Clinic/Center in Little River, SC

Joined Together Marriage& Family Llc
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Mcleod Regional Medical Center Of The Pee Dee, Inc
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Creating Meaning Counseling Services Llc
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Phone: 740-703-0729    
Optimum Mental Health Llc
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Jazz & Coco Llc
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Phone: 843-685-0998    Fax: 843-695-7681
Seacoast Neurology Associates
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 4000 Highway 9 E, Suite 255, Little River, SC 29566
Phone: 843-390-8310    Fax: 843-390-8319

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.