| Caresouth Carolina, Inc. | |
|
1268 S 4th St Hartsville SC 29550-0703 | |
| (843) 332-3422 | |
| Not Available |
| Full Name | Caresouth Carolina, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1268 S 4th St, Hartsville, South Carolina |
| Authorized Official Name and Position | Ann Lewis (CEO) |
| Authorized Official Contact | 8438570111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caresouth Carolina, Inc. 201 S 5th St Hartsville SC 29550-4211 Ph: () - | Caresouth Carolina, Inc. 1268 S 4th St Hartsville SC 29550-0703 Ph: (843) 332-3422 |
| NPI Number | 1720082571 |
|---|---|
| Provider Enumeration Date | 06/09/2005 |
| Last Update Date | 09/04/2007 |
| Medicare PECOS PAC ID | 1052221314 |
|---|---|
| Medicare Enrollment ID | O20040511000280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720082571 | NPI | - | NPPES |
| CBP011 | Medicaid | SC | |
| FQC015 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Zenaida Candela |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316051139 PECOS PAC ID: 7719967751 Enrollment ID: I20040721001097 |
| Provider Name | Sylvia Mckoy Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518070531 PECOS PAC ID: 1951374081 Enrollment ID: I20040817000944 |
| Provider Name | Cindy G Crittendon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023017506 PECOS PAC ID: 7517935141 Enrollment ID: I20040922000151 |
| Provider Name | Stephen L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255444386 PECOS PAC ID: 2163471228 Enrollment ID: I20050114000628 |
| Provider Name | Patricia E Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356456628 PECOS PAC ID: 7315952744 Enrollment ID: I20060207000371 |
| Provider Name | Mark W Sohner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780687624 PECOS PAC ID: 0840293163 Enrollment ID: I20060807000082 |
| Provider Name | Christina Biester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891700506 PECOS PAC ID: 6406859495 Enrollment ID: I20060811000259 |
| Provider Name | Barbara A Wright-bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437123924 PECOS PAC ID: 3476555368 Enrollment ID: I20070206000223 |
| Provider Name | Jane Elizabeth Whiteside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740484757 PECOS PAC ID: 7719071554 Enrollment ID: I20070924000511 |
| Provider Name | Jesse M West |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1609850825 PECOS PAC ID: 8729176201 Enrollment ID: I20071116000266 |
| Provider Name | Jeniqua J Duncan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316130800 PECOS PAC ID: 4284723289 Enrollment ID: I20071128000516 |
| Provider Name | Johnathan C Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982843025 PECOS PAC ID: 2466501234 Enrollment ID: I20090527000510 |
| Provider Name | Elizabeth K Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760634414 PECOS PAC ID: 9436208071 Enrollment ID: I20090601000303 |
| Provider Name | Heather M Worsham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891926606 PECOS PAC ID: 6002961018 Enrollment ID: I20090827000004 |
| Provider Name | Ellen Margaret Mishra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417020751 PECOS PAC ID: 9537176763 Enrollment ID: I20091006000722 |
| Provider Name | Douglas Eli Cunningham |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1699761874 PECOS PAC ID: 5799816286 Enrollment ID: I20100628000354 |
| Provider Name | Jeri Lynn Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366763385 PECOS PAC ID: 5092831347 Enrollment ID: I20100924000186 |
| Provider Name | Jack W Rhyne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841270212 PECOS PAC ID: 4981893096 Enrollment ID: I20110105000493 |
| Provider Name | James B Fleming |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841525631 PECOS PAC ID: 6305024332 Enrollment ID: I20110622000422 |
| Provider Name | Gregory Connor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265422992 PECOS PAC ID: 2567483084 Enrollment ID: I20111202000375 |
| Provider Name | Jackie M Stafford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609150622 PECOS PAC ID: 6800062415 Enrollment ID: I20120104000007 |
| Provider Name | John D Hyatt |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184696346 PECOS PAC ID: 0648465682 Enrollment ID: I20120731000374 |
| Provider Name | Jeffrey M Brock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992966352 PECOS PAC ID: 5890943864 Enrollment ID: I20120917000431 |
| Provider Name | Lauren Worsham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134359029 PECOS PAC ID: 0042445512 Enrollment ID: I20131109000012 |
| Provider Name | Cecilia Dyllis Boafoah Aduako |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679606867 PECOS PAC ID: 8527162080 Enrollment ID: I20131126000512 |
| Provider Name | Amy Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710314570 PECOS PAC ID: 8921235268 Enrollment ID: I20131212001346 |
| Provider Name | Levina Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932521218 PECOS PAC ID: 3274757059 Enrollment ID: I20140618000144 |
| Provider Name | Ellen Mabe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659785954 PECOS PAC ID: 9133345804 Enrollment ID: I20140801001480 |
| Provider Name | Tara Coburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023407368 PECOS PAC ID: 6406172485 Enrollment ID: I20150310001942 |
| Provider Name | Angela Council |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821480195 PECOS PAC ID: 0042523482 Enrollment ID: I20150714002918 |
| Provider Name | Jennifer Mclester Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740663038 PECOS PAC ID: 8022324490 Enrollment ID: I20150831001548 |
| Provider Name | Sarah C Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497137533 PECOS PAC ID: 0345557252 Enrollment ID: I20150909002255 |
| Provider Name | Samantha C Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730562810 PECOS PAC ID: 6204144009 Enrollment ID: I20150928002615 |
| Provider Name | Kendra M Fling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427435940 PECOS PAC ID: 5890004741 Enrollment ID: I20151016000717 |
| Provider Name | Earline Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487073219 PECOS PAC ID: 5395042634 Enrollment ID: I20160331000569 |
| Provider Name | Alexia W Mckoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508210501 PECOS PAC ID: 2062703275 Enrollment ID: I20160620000393 |
| Provider Name | Asya Elizabeth Penzo-shumard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376994335 PECOS PAC ID: 6406141571 Enrollment ID: I20160829001255 |
| Provider Name | Adam M Gude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225482524 PECOS PAC ID: 7810285293 Enrollment ID: I20161018002132 |
| Provider Name | Edward Chaum |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023075868 PECOS PAC ID: 6406898493 Enrollment ID: I20161212000784 |
| Provider Name | Tracy J Teal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851511992 PECOS PAC ID: 4284901273 Enrollment ID: I20170523000583 |
| Provider Name | Heather D Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841721529 PECOS PAC ID: 2668740937 Enrollment ID: I20170612000400 |
| Provider Name | Kristopher Olen Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306378856 PECOS PAC ID: 0143599233 Enrollment ID: I20170705002434 |
| Provider Name | Mary D Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437579083 PECOS PAC ID: 5496025066 Enrollment ID: I20170714002097 |
| Provider Name | Danielle G Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447602057 PECOS PAC ID: 9032480645 Enrollment ID: I20170731003697 |
| Provider Name | Liston Alexander Weatherly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912413832 PECOS PAC ID: 9436411188 Enrollment ID: I20180319000505 |
| Provider Name | Ludie Kathleen Floyd-moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497247241 PECOS PAC ID: 2163771775 Enrollment ID: I20180815001139 |
| Provider Name | Travis Andre Russell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1861976839 PECOS PAC ID: 9830443597 Enrollment ID: I20181115000922 |
| Provider Name | Gilberto Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588159628 PECOS PAC ID: 7911241427 Enrollment ID: I20181210001754 |
| Provider Name | Joshua Hubbard |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225480049 PECOS PAC ID: 0648512913 Enrollment ID: I20190507001815 |
| Provider Name | Katelon Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033673405 PECOS PAC ID: 5890037097 Enrollment ID: I20190508000197 |
| Provider Name | Temeka Justine Ruth Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003477373 PECOS PAC ID: 5890022008 Enrollment ID: I20190812001146 |
| Provider Name | Brandi Rollins Hair |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568963593 PECOS PAC ID: 1850620790 Enrollment ID: I20190903000502 |
| Provider Name | Teresa Samuel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235489832 PECOS PAC ID: 0547529141 Enrollment ID: I20190903002583 |
| Provider Name | Daniel R Conner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144670266 PECOS PAC ID: 6103119854 Enrollment ID: I20191120003383 |
| Provider Name | Haley Elizabeth Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245878487 PECOS PAC ID: 9638507544 Enrollment ID: I20200306001250 |
| Provider Name | Jana Ebbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417373986 PECOS PAC ID: 7810261328 Enrollment ID: I20200702002045 |
| Provider Name | Chatonia Renee Smalls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972131225 PECOS PAC ID: 2860816055 Enrollment ID: I20200721002650 |
| Provider Name | Clara Miguelina Cabrera Fermin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669902011 PECOS PAC ID: 5193094621 Enrollment ID: I20210125002005 |
| Provider Name | Mekesha Danielle Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922589704 PECOS PAC ID: 8527474139 Enrollment ID: I20210305001616 |
| Provider Name | Staci Leigh Cassidy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043892920 PECOS PAC ID: 9537565056 Enrollment ID: I20210909000890 |
| Provider Name | Demarcus Benjamin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902574486 PECOS PAC ID: 3678970423 Enrollment ID: I20210922000984 |
| Provider Name | Shankana Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326587387 PECOS PAC ID: 3971992744 Enrollment ID: I20211116003163 |
| Provider Name | Dana Robinson Steen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407487689 PECOS PAC ID: 0345630919 Enrollment ID: I20211214002429 |
| Provider Name | Joe L Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588335962 PECOS PAC ID: 6103217658 Enrollment ID: I20211217000569 |
| Provider Name | Tasha Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609532811 PECOS PAC ID: 9638560881 Enrollment ID: I20211222001407 |
| Provider Name | Catherine M Compton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457883415 PECOS PAC ID: 4183992787 Enrollment ID: I20220127002049 |
| Provider Name | Sheila Michelle Blossom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508524521 PECOS PAC ID: 5597150748 Enrollment ID: I20220324002670 |
| Provider Name | Daisha Jerrice Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184394918 PECOS PAC ID: 6507252228 Enrollment ID: I20220406001025 |
| Provider Name | Courtney Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962095612 PECOS PAC ID: 8426447376 Enrollment ID: I20220610001856 |
| Provider Name | Jocelyn Boyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063069441 PECOS PAC ID: 2264811884 Enrollment ID: I20220628000569 |
| Provider Name | Leandria Nichelle Bivens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952944969 PECOS PAC ID: 2062888472 Enrollment ID: I20221026000148 |
| Provider Name | Sharonda Rawls Legette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821714965 PECOS PAC ID: 8921477282 Enrollment ID: I20221207003091 |
| Provider Name | Amy Weir Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679296396 PECOS PAC ID: 8729459276 Enrollment ID: I20230120002187 |
| Provider Name | Zita Acuna Andreski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003543539 PECOS PAC ID: 3375915382 Enrollment ID: I20230220002132 |
| Provider Name | Sumner Garland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952760449 PECOS PAC ID: 2365890837 Enrollment ID: I20231121003002 |
| Provider Name | Pamela L Jones-monroe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467776583 PECOS PAC ID: 0648620682 Enrollment ID: I20240103001114 |
| Provider Name | Robin Hope Gibson |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1992984082 PECOS PAC ID: 8426408410 Enrollment ID: I20240103002963 |
| Provider Name | Courtney Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861264327 PECOS PAC ID: 7416308291 Enrollment ID: I20240105000931 |
| Provider Name | Vishali Aygari |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275687691 PECOS PAC ID: 7719293232 Enrollment ID: I20240110003811 |
| Provider Name | Carolyn Whitfield Fulmore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487766549 PECOS PAC ID: 6507192333 Enrollment ID: I20240122000580 |
| Provider Name | Cynthia H. Griffin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033537188 PECOS PAC ID: 3375996408 Enrollment ID: I20240125000882 |
| Provider Name | Tabitha Gail Hennagan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689981276 PECOS PAC ID: 5991158560 Enrollment ID: I20240130003659 |
| Provider Name | Daniel P Owens |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750544250 PECOS PAC ID: 7719016039 Enrollment ID: I20240213002589 |
| Provider Name | Lora C Chavis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760821078 PECOS PAC ID: 8224343579 Enrollment ID: I20240226000149 |
| Provider Name | Bradley Burgess |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730480971 PECOS PAC ID: 1951619667 Enrollment ID: I20240227002622 |
| Provider Name | John Fulmer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528087467 PECOS PAC ID: 1052757481 Enrollment ID: I20240307004057 |
| Provider Name | Jessica Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104221811 PECOS PAC ID: 8325488968 Enrollment ID: I20240430003515 |
Carolina Nephrology And Endocrinology, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1015 S 4th St, Hartsville, SC 29550 Phone: 843-861-4342 Fax: 866-230-9736 | |
Compassionate Care Of Hartsville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 750 W Carolina Ave, Hartsville, SC 29550 Phone: 843-951-9990 Fax: 843-951-9989 | |
Palmetto Family Medicine And Senior Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 420 W Carolina Ave, Hartsville, SC 29550 Phone: 843-917-4977 Fax: 888-854-0390 | |
The Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Medical Park Dr, Suite 301, Hartsville, SC 29550 Phone: 843-878-1004 Fax: 843-332-9229 | |
Pee Dee Health Care Hartsville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 S 2nd Street, Hartsville, SC 29550 Phone: 843-383-4994 Fax: 843-332-5473 | |
Magnolia Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 504 Segars Mill Rd, Hartsville, SC 29550 Phone: 843-621-0799 | |
Southern Comfort Health And Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1032 Bentwood Rd, Hartsville, SC 29550 Phone: 843-773-0979 |