| Carolina Diabetes & Kidney Center, Llc | |
|
625 W Wesmark Blvd Sumter SC 29150-1900 | |
| (803) 469-7950 | |
| (803) 469-7548 |
| Full Name | Carolina Diabetes & Kidney Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 625 W Wesmark Blvd, Sumter, South Carolina |
| Authorized Official Name and Position | Usah Lilavivat (PRESIDENT) |
| Authorized Official Contact | 8034697950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Diabetes & Kidney Center, Llc 625 W Wesmark Blvd Sumter SC 29150-1900 Ph: (803) 469-7950 | Carolina Diabetes & Kidney Center, Llc 625 W Wesmark Blvd Sumter SC 29150-1900 Ph: (803) 469-7950 |
| NPI Number | 1689128951 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Medicare PECOS PAC ID | 2365723806 |
|---|---|
| Medicare Enrollment ID | O20161221001632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689128951 | NPI | - | NPPES |
| Provider Name | Usah Lilavivat |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1437241262 PECOS PAC ID: 6608768726 Enrollment ID: I20040325000626 |
| Provider Name | Celia M Herring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821258435 PECOS PAC ID: 8921171505 Enrollment ID: I20080715000367 |
| Provider Name | Cheryl R Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881764595 PECOS PAC ID: 1951343789 Enrollment ID: I20110711000542 |
| Provider Name | Tracy D Ridgill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558674812 PECOS PAC ID: 0648449355 Enrollment ID: I20110815000888 |
| Provider Name | Jeffrey Rossi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306080973 PECOS PAC ID: 4486887288 Enrollment ID: I20140501001328 |
| Provider Name | Belinda H Pickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356746630 PECOS PAC ID: 0749504785 Enrollment ID: I20150121001772 |
| Provider Name | Barbara H Carden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225467707 PECOS PAC ID: 3870721400 Enrollment ID: I20150324002420 |
| Provider Name | Makala K Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083017222 PECOS PAC ID: 5092021717 Enrollment ID: I20150826000753 |
| Provider Name | Allison Stroughton Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013369453 PECOS PAC ID: 5991089286 Enrollment ID: I20170306001444 |
| Provider Name | Geovani Faddoul |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164717054 PECOS PAC ID: 6507134533 Enrollment ID: I20170616000232 |
| Provider Name | Shameem Beigh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194072405 PECOS PAC ID: 7315294931 Enrollment ID: I20180727000119 |
| Provider Name | Issra Jamal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1457792871 PECOS PAC ID: 2860628690 Enrollment ID: I20181119003320 |
| Provider Name | Brett Duke Lynam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780246348 PECOS PAC ID: 1658602420 Enrollment ID: I20191009000130 |
| Provider Name | Daniel William Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447872643 PECOS PAC ID: 4981015229 Enrollment ID: I20201118000690 |
| Provider Name | Juanly Nefatli Rodriguez |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740708221 PECOS PAC ID: 2062890544 Enrollment ID: I20220613001326 |
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Invostix Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 E Wesmark Blvd Ste 2, Sumter, SC 29150 Phone: 803-757-1238 | |
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