| Highway To Hope Tri-county Primary Care | |
|
1035 Cheraw St Bennettsville SC 29512-2422 | |
| (843) 454-0442 | |
| Not Available |
| Full Name | Highway To Hope Tri-county Primary Care |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1035 Cheraw St, Bennettsville, South Carolina |
| Authorized Official Name and Position | Tracy L Turner (CONROLLER) |
| Authorized Official Contact | 8038988503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Highway To Hope Tri-county Primary Care 1035 Cheraw St Bennettsville SC 29512-2422 Ph: (843) 454-0442 | Highway To Hope Tri-county Primary Care 1035 Cheraw St Bennettsville SC 29512-2422 Ph: (843) 454-0442 |
| NPI Number | 1295332690 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 11/06/2020 |
| Medicare PECOS PAC ID | 9032021175 |
|---|---|
| Medicare Enrollment ID | O20031107000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295332690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | James Edward Ford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871530444 PECOS PAC ID: 0941105217 Enrollment ID: I20031201000588 |
| Provider Name | Eman M Sharawy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902998032 PECOS PAC ID: 4688579857 Enrollment ID: I20031201000626 |
| Provider Name | Donna Clair Orvin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699712539 PECOS PAC ID: 1153222088 Enrollment ID: I20040115000136 |
| Provider Name | Simi Sachdev |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093827198 PECOS PAC ID: 6305730581 Enrollment ID: I20040210000041 |
| Provider Name | Paul I Robbins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780757237 PECOS PAC ID: 4183514318 Enrollment ID: I20040319000222 |
| Provider Name | David A Justice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649290362 PECOS PAC ID: 7719878750 Enrollment ID: I20040322000319 |
| Provider Name | Ayodele A Ogunfowora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073578506 PECOS PAC ID: 7810982808 Enrollment ID: I20040419000906 |
| Provider Name | Ann Marie Menendez-caldwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275707143 PECOS PAC ID: 4082604376 Enrollment ID: I20040518000190 |
| Provider Name | Alfred R Ebert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336231851 PECOS PAC ID: 2567444953 Enrollment ID: I20040601000793 |
| Provider Name | Janet Diane Woolery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508835489 PECOS PAC ID: 5193708584 Enrollment ID: I20040608000640 |
| Provider Name | Shalini Mittal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538198676 PECOS PAC ID: 7517942048 Enrollment ID: I20040621000312 |
| Provider Name | Lisa A Cometto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649222779 PECOS PAC ID: 2365412087 Enrollment ID: I20040729001066 |
| Provider Name | Marion H Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760430573 PECOS PAC ID: 8022080225 Enrollment ID: I20040811000042 |
| Provider Name | Deidre Jane Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902878218 PECOS PAC ID: 5496729592 Enrollment ID: I20040824000954 |
| Provider Name | Vonda K Gravely |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053382259 PECOS PAC ID: 3870554322 Enrollment ID: I20041019001028 |
| Provider Name | Eric Karl Winter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851482210 PECOS PAC ID: 5890752448 Enrollment ID: I20041215000193 |
| Provider Name | Janice C Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699723106 PECOS PAC ID: 4082664677 Enrollment ID: I20050201000301 |
| Provider Name | Marian Dehlinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720104565 PECOS PAC ID: 4385695741 Enrollment ID: I20050203000250 |
| Provider Name | Kathy Marie Waggett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467400671 PECOS PAC ID: 2961457155 Enrollment ID: I20050321000908 |
| Provider Name | Gaye M Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396719258 PECOS PAC ID: 3375599723 Enrollment ID: I20050329000481 |
| Provider Name | Jaime W Koenig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992779607 PECOS PAC ID: 9931148707 Enrollment ID: I20050502000054 |
| Provider Name | Warren B Garrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922073659 PECOS PAC ID: 4880633460 Enrollment ID: I20050503000615 |
| Provider Name | James Emery Claytor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558335281 PECOS PAC ID: 2264471853 Enrollment ID: I20050503000756 |
| Provider Name | Martha C Freibert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144295874 PECOS PAC ID: 3375583966 Enrollment ID: I20050503000830 |
| Provider Name | Robert L Bank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982678686 PECOS PAC ID: 3577503176 Enrollment ID: I20050503000896 |
| Provider Name | James F Riddle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225003973 PECOS PAC ID: 2567402175 Enrollment ID: I20050503000999 |
| Provider Name | Radhika D Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326013061 PECOS PAC ID: 5597705111 Enrollment ID: I20050503001052 |
| Provider Name | Ada Nwankudu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174595060 PECOS PAC ID: 3870513617 Enrollment ID: I20051123000132 |
| Provider Name | Merrie A Cherry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336287762 PECOS PAC ID: 1052331709 Enrollment ID: I20051128000279 |
| Provider Name | Michelle Bruce Nobles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992777007 PECOS PAC ID: 1153343363 Enrollment ID: I20051230000279 |
| Provider Name | Shilpa Srinivasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639105232 PECOS PAC ID: 2961434691 Enrollment ID: I20060803000208 |
| Provider Name | Mayank H Dalal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457384935 PECOS PAC ID: 7517964117 Enrollment ID: I20061024000324 |
| Provider Name | Deepa Sobti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124058458 PECOS PAC ID: 3577564566 Enrollment ID: I20070117000406 |
| Provider Name | Melinda E Edwards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245252774 PECOS PAC ID: 1254435027 Enrollment ID: I20070404000108 |
| Provider Name | Delfin Valite |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295794428 PECOS PAC ID: 0749241990 Enrollment ID: I20070604000104 |
| Provider Name | Edmund S Higgins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013021153 PECOS PAC ID: 9133210537 Enrollment ID: I20070814000125 |
| Provider Name | Carl W Brune |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912934191 PECOS PAC ID: 9133201593 Enrollment ID: I20080124000518 |
| Provider Name | Melanie A Lobel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013033273 PECOS PAC ID: 7214015361 Enrollment ID: I20080415000579 |
| Provider Name | Ruth C Walkup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134285448 PECOS PAC ID: 1850469875 Enrollment ID: I20081003000603 |
| Provider Name | Dong-ha Chung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487857645 PECOS PAC ID: 0446310007 Enrollment ID: I20081201000067 |
| Provider Name | Pravina Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700810561 PECOS PAC ID: 5799848750 Enrollment ID: I20090116000499 |
| Provider Name | Margaret S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750535530 PECOS PAC ID: 3375691553 Enrollment ID: I20090427000528 |
| Provider Name | Ralph C Pollock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215069034 PECOS PAC ID: 9739231382 Enrollment ID: I20090714000095 |
| Provider Name | Lori W Barwick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518069855 PECOS PAC ID: 4587716030 Enrollment ID: I20090715000245 |
| Provider Name | Hossan A Hassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346226453 PECOS PAC ID: 4688727340 Enrollment ID: I20090729000258 |
| Provider Name | Ajay Sood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881803641 PECOS PAC ID: 4486782471 Enrollment ID: I20100512000758 |
| Provider Name | Graeme H Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336175603 PECOS PAC ID: 5597896852 Enrollment ID: I20100630000360 |
| Provider Name | Elin B Berg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033399126 PECOS PAC ID: 4284765256 Enrollment ID: I20100708000710 |
| Provider Name | John Pybass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891913455 PECOS PAC ID: 3577695733 Enrollment ID: I20100723000229 |
| Provider Name | Michael N Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952513830 PECOS PAC ID: 5890829279 Enrollment ID: I20100820000589 |
| Provider Name | Srinivasa R Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356437743 PECOS PAC ID: 3678677135 Enrollment ID: I20101111000460 |
| Provider Name | Allen Edward Gamble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265493605 PECOS PAC ID: 2365622354 Enrollment ID: I20110208000811 |
| Provider Name | James P Mazgaj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912039108 PECOS PAC ID: 8123209327 Enrollment ID: I20110222000209 |
| Provider Name | Kalpana Shanmugam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285827402 PECOS PAC ID: 9133302995 Enrollment ID: I20110331000792 |
| Provider Name | Prentis Gunter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699826164 PECOS PAC ID: 0547255028 Enrollment ID: I20110408000554 |
| Provider Name | Patrick T Butterfield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003900507 PECOS PAC ID: 5799961579 Enrollment ID: I20110511000612 |
| Provider Name | Henry M Timms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528143658 PECOS PAC ID: 2062680432 Enrollment ID: I20110801000029 |
| Provider Name | Christian F Reusche |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932306545 PECOS PAC ID: 3678742244 Enrollment ID: I20110816000705 |
| Provider Name | Randall Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497705396 PECOS PAC ID: 8921278003 Enrollment ID: I20110829000005 |
| Provider Name | Gariane P Gunter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386774974 PECOS PAC ID: 1658544309 Enrollment ID: I20111025000908 |
| Provider Name | Holly Clark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346453727 PECOS PAC ID: 2961675418 Enrollment ID: I20111029000009 |
| Provider Name | Judith E Tolhurst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083766711 PECOS PAC ID: 9739369018 Enrollment ID: I20111116000913 |
| Provider Name | Raymond M Kimball |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285668608 PECOS PAC ID: 7517131667 Enrollment ID: I20111129000668 |
| Provider Name | Mark Charles Feinstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033176755 PECOS PAC ID: 1456253517 Enrollment ID: I20111208000731 |
| Provider Name | William D Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184717001 PECOS PAC ID: 3274708789 Enrollment ID: I20111213000003 |
| Provider Name | Eunice Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164547683 PECOS PAC ID: 8729253091 Enrollment ID: I20111215000012 |
| Provider Name | Kathleen M Lundvall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508919879 PECOS PAC ID: 6709053234 Enrollment ID: I20120124000249 |
| Provider Name | Christie R Williamson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912926544 PECOS PAC ID: 7810154036 Enrollment ID: I20120131000235 |
| Provider Name | Catherine J Kreiser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316040587 PECOS PAC ID: 5294992434 Enrollment ID: I20120131000471 |
| Provider Name | Jagdish V Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356301360 PECOS PAC ID: 2668421025 Enrollment ID: I20120202000414 |
| Provider Name | Jane Elizabeth Watson Alford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447341623 PECOS PAC ID: 8527225523 Enrollment ID: I20120202000493 |
| Provider Name | Eugene F Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114905130 PECOS PAC ID: 8426215344 Enrollment ID: I20120206000190 |
| Provider Name | Janis S Browning |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1851494082 PECOS PAC ID: 0042477465 Enrollment ID: I20120213000478 |
| Provider Name | Laurel A Weston |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588755938 PECOS PAC ID: 7012175375 Enrollment ID: I20120216000477 |
| Provider Name | Tanya C Dillihay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710999321 PECOS PAC ID: 4486812351 Enrollment ID: I20120223000249 |
| Provider Name | Deanna Guith Cornelius |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982716437 PECOS PAC ID: 4981863990 Enrollment ID: I20120312000388 |
| Provider Name | Philip C Bowman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639291669 PECOS PAC ID: 6901865518 Enrollment ID: I20120329000267 |
| Provider Name | Kontasha Shamika Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679850044 PECOS PAC ID: 5395906960 Enrollment ID: I20120409000685 |
| Provider Name | Jean Williams-bowens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386814648 PECOS PAC ID: 5890859623 Enrollment ID: I20120614000216 |
| Provider Name | Daniel J Uderitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295963437 PECOS PAC ID: 1658528815 Enrollment ID: I20120823000718 |
| Provider Name | Celine M Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447585815 PECOS PAC ID: 2264682293 Enrollment ID: I20121026000610 |
| Provider Name | Lauretta T Mona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346343514 PECOS PAC ID: 7113917907 Enrollment ID: I20130916000203 |
| Provider Name | Cheryl Ann Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013094093 PECOS PAC ID: 4587621909 Enrollment ID: I20140721000668 |
| Provider Name | Kun Tang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275849440 PECOS PAC ID: 1254559404 Enrollment ID: I20140829000493 |
| Provider Name | Leilani V Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619147055 PECOS PAC ID: 8123276185 Enrollment ID: I20141016001784 |
| Provider Name | Stanley R Coleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760498802 PECOS PAC ID: 9335361591 Enrollment ID: I20141104001574 |
| Provider Name | Francis Robert Peluso |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366682841 PECOS PAC ID: 0042486979 Enrollment ID: I20141119002170 |
| Provider Name | Mark F Meglino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699834143 PECOS PAC ID: 8820311566 Enrollment ID: I20150102001360 |
| Provider Name | Daniel John Balog |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710036470 PECOS PAC ID: 4688998263 Enrollment ID: I20150130002282 |
| Provider Name | Queen J Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326148453 PECOS PAC ID: 7214240704 Enrollment ID: I20150713001477 |
| Provider Name | Kimberly Bush |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083704837 PECOS PAC ID: 6103990643 Enrollment ID: I20150714001881 |
| Provider Name | Felicia Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508141854 PECOS PAC ID: 6002081585 Enrollment ID: I20150721000264 |
| Provider Name | Jennifer Ann Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952709057 PECOS PAC ID: 0244547214 Enrollment ID: I20150923003208 |
| Provider Name | Nikunjkumar Trambaklal Modi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003131343 PECOS PAC ID: 1658671128 Enrollment ID: I20151207000077 |
| Provider Name | Khoa Dang Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346458908 PECOS PAC ID: 8628977675 Enrollment ID: I20160127002348 |
| Provider Name | Debra A Bjork |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033429568 PECOS PAC ID: 5991009730 Enrollment ID: I20160215001945 |
| Provider Name | Martha G Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790822450 PECOS PAC ID: 4880587328 Enrollment ID: I20160225001846 |
| Provider Name | Hector Diaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407818081 PECOS PAC ID: 0941102594 Enrollment ID: I20160321000018 |
| Provider Name | Manojbhai P Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104926153 PECOS PAC ID: 8729248208 Enrollment ID: I20160721000201 |
| Provider Name | Brittany R Peters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841463163 PECOS PAC ID: 3577841733 Enrollment ID: I20161024001478 |
| Provider Name | Meenakshi Parmar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417170143 PECOS PAC ID: 6709953417 Enrollment ID: I20161205001740 |
| Provider Name | Brittany Schafer Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780996280 PECOS PAC ID: 9638452311 Enrollment ID: I20170202001710 |
| Provider Name | Allison F Defelice |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306807573 PECOS PAC ID: 1153604566 Enrollment ID: I20170209001360 |
| Provider Name | Carolyn Waiboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992240394 PECOS PAC ID: 9436434958 Enrollment ID: I20170324001757 |
| Provider Name | Ilias Nigamatov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497831820 PECOS PAC ID: 4789772567 Enrollment ID: I20170327000863 |
| Provider Name | Melinda A Thiam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225291339 PECOS PAC ID: 6709018419 Enrollment ID: I20171108001903 |
| Provider Name | Kristin Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316459860 PECOS PAC ID: 1456618263 Enrollment ID: I20171204002362 |
| Provider Name | Elizabeth L Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447409735 PECOS PAC ID: 7618237215 Enrollment ID: I20180130001186 |
| Provider Name | Dorothy A Burkett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588173124 PECOS PAC ID: 4082975917 Enrollment ID: I20180309000971 |
| Provider Name | Elizabeth J Eggebrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174038590 PECOS PAC ID: 9032471776 Enrollment ID: I20180316002222 |
| Provider Name | Natalie Verenes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477068864 PECOS PAC ID: 7012279508 Enrollment ID: I20180321000960 |
| Provider Name | Gertrude E Stoney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326547431 PECOS PAC ID: 1052673001 Enrollment ID: I20180403000639 |
| Provider Name | Timekia Renee Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326542887 PECOS PAC ID: 9436414885 Enrollment ID: I20180605003569 |
| Provider Name | Emma L Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407373475 PECOS PAC ID: 0244595643 Enrollment ID: I20180606002193 |
| Provider Name | Mariano L Razon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356844278 PECOS PAC ID: 4284981739 Enrollment ID: I20180716001929 |
| Provider Name | Isabella Adjinah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710242151 PECOS PAC ID: 7911255583 Enrollment ID: I20180731000106 |
| Provider Name | Jennifer J Gustavsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427309012 PECOS PAC ID: 4688824055 Enrollment ID: I20180813003333 |
| Provider Name | Caitlin S Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083109300 PECOS PAC ID: 7517216476 Enrollment ID: I20180827000650 |
| Provider Name | Felicia Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659637957 PECOS PAC ID: 7911257985 Enrollment ID: I20180912002854 |
| Provider Name | Brynna Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689925570 PECOS PAC ID: 7416208376 Enrollment ID: I20180919004184 |
| Provider Name | Megan Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528545209 PECOS PAC ID: 9830441716 Enrollment ID: I20181003002139 |
| Provider Name | Deborah R Whatley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184110900 PECOS PAC ID: 1052663374 Enrollment ID: I20181015000406 |
| Provider Name | Peter Louis Loper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992090765 PECOS PAC ID: 2961746896 Enrollment ID: I20181204002743 |
| Provider Name | Roberta Jean Monroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497225346 PECOS PAC ID: 8224375308 Enrollment ID: I20190128002073 |
| Provider Name | Ilva Genoveva Iriarte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952663445 PECOS PAC ID: 1557650223 Enrollment ID: I20190205002403 |
| Provider Name | Stacey Lynn Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093226789 PECOS PAC ID: 2567720592 Enrollment ID: I20190312002652 |
| Provider Name | Sharon E Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750628947 PECOS PAC ID: 8325389612 Enrollment ID: I20190415002151 |
| Provider Name | Alton Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396150751 PECOS PAC ID: 2860792421 Enrollment ID: I20190430002672 |
| Provider Name | Katie Chambers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770921751 PECOS PAC ID: 9739421025 Enrollment ID: I20190507002854 |
| Provider Name | Patrick Wiita |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841558772 PECOS PAC ID: 8921341017 Enrollment ID: I20190513000597 |
| Provider Name | Joshua Lee Lagrant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750601910 PECOS PAC ID: 9436483401 Enrollment ID: I20190625001632 |
| Provider Name | Xavier W Belcher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245525674 PECOS PAC ID: 1557670817 Enrollment ID: I20190628001592 |
| Provider Name | Kendrick Maurice James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538522560 PECOS PAC ID: 3870829278 Enrollment ID: I20190723002334 |
| Provider Name | Alkesh Bhupendra Gajjar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841506227 PECOS PAC ID: 7113143736 Enrollment ID: I20190725001982 |
| Provider Name | Katelin Jean Williamson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477967859 PECOS PAC ID: 1850627530 Enrollment ID: I20190802000287 |
| Provider Name | Robert Ryan Leahy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679917900 PECOS PAC ID: 6507002169 Enrollment ID: I20190904003324 |
| Provider Name | Carol Little Sena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447311519 PECOS PAC ID: 0345134466 Enrollment ID: I20190909002582 |
| Provider Name | Stephanie M Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699113720 PECOS PAC ID: 8921394933 Enrollment ID: I20200127001727 |
| Provider Name | Roopma Wadhwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255711545 PECOS PAC ID: 4688972979 Enrollment ID: I20200211002614 |
| Provider Name | Amanda Vance Clough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861741530 PECOS PAC ID: 2062840747 Enrollment ID: I20200311000850 |
| Provider Name | Lauren N Tucker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548642721 PECOS PAC ID: 6608165451 Enrollment ID: I20200317002727 |
| Provider Name | Kimberly M Cannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528396447 PECOS PAC ID: 3971931122 Enrollment ID: I20200321000500 |
| Provider Name | Kristi Michelle Ernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679045017 PECOS PAC ID: 6002246410 Enrollment ID: I20200428000128 |
| Provider Name | Frank Andrew Peters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164802807 PECOS PAC ID: 7517398720 Enrollment ID: I20200501002842 |
| Provider Name | Vikas Gupta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194144311 PECOS PAC ID: 6305069741 Enrollment ID: I20200506000849 |
| Provider Name | Jasita Sachar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629450879 PECOS PAC ID: 9931418993 Enrollment ID: I20200526000415 |
| Provider Name | Benjamin David Potter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821382748 PECOS PAC ID: 8527357698 Enrollment ID: I20200601003001 |
| Provider Name | Katie Thomas Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720563463 PECOS PAC ID: 1850626979 Enrollment ID: I20200626001278 |
| Provider Name | Michelle Duncan Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578930574 PECOS PAC ID: 2567895949 Enrollment ID: I20200630001783 |
| Provider Name | Teyanna Joyce Dillingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467925206 PECOS PAC ID: 3870916265 Enrollment ID: I20200701002170 |
| Provider Name | Gerald Orbia Deel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740763697 PECOS PAC ID: 7315360658 Enrollment ID: I20200706001429 |
| Provider Name | Ebony Gaffney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184851958 PECOS PAC ID: 1153565296 Enrollment ID: I20201021000719 |
| Provider Name | Tyease R Mosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700429453 PECOS PAC ID: 8325465610 Enrollment ID: I20201109002057 |
| Provider Name | Anna Burnett Seegars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124643812 PECOS PAC ID: 0547677353 Enrollment ID: I20210323001629 |
| Provider Name | Naterea Holley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487200770 PECOS PAC ID: 7315354925 Enrollment ID: I20210326001784 |
| Provider Name | Carolyn Harkness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376008813 PECOS PAC ID: 3577803659 Enrollment ID: I20210419001553 |
| Provider Name | Elizabeth A Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225627490 PECOS PAC ID: 9739597030 Enrollment ID: I20210427001627 |
| Provider Name | Michael G Singleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346707361 PECOS PAC ID: 5991104135 Enrollment ID: I20210520001851 |
| Provider Name | Towanna Shanett Lance Enoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982709069 PECOS PAC ID: 1254568355 Enrollment ID: I20210526002470 |
| Provider Name | Carla Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790905826 PECOS PAC ID: 8224153911 Enrollment ID: I20210603001279 |
| Provider Name | Tammara Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386844603 PECOS PAC ID: 1850481193 Enrollment ID: I20210804003694 |
| Provider Name | Magnus Lakovics |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861490963 PECOS PAC ID: 4183795958 Enrollment ID: I20210920003472 |
| Provider Name | Jennifer Szelistowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518498633 PECOS PAC ID: 8527466382 Enrollment ID: I20211007003140 |
| Provider Name | Jason R Kearnes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164871273 PECOS PAC ID: 0749563625 Enrollment ID: I20211123002819 |
| Provider Name | Lois Koshay Freeman-arnold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164585287 PECOS PAC ID: 7719377480 Enrollment ID: I20211213000820 |
| Provider Name | Akila S Boozer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316594724 PECOS PAC ID: 8729472956 Enrollment ID: I20220303001060 |
| Provider Name | Lisa Ann Oshaughnessy Turnure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396252219 PECOS PAC ID: 3375881097 Enrollment ID: I20220502000011 |
| Provider Name | Wayne Denton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174580153 PECOS PAC ID: 8123045531 Enrollment ID: I20220525002009 |
| Provider Name | Tempesst Merricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407314081 PECOS PAC ID: 3678813706 Enrollment ID: I20220706001086 |
| Provider Name | Kellane Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912372905 PECOS PAC ID: 2264728278 Enrollment ID: I20230209001522 |
| Provider Name | Laroysha Shawntae Ulmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598430647 PECOS PAC ID: 5799140810 Enrollment ID: I20230425001531 |
| Provider Name | Micah Burris Williford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104432798 PECOS PAC ID: 9234597105 Enrollment ID: I20230626000586 |
| Provider Name | Regina Kaye Beckham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548325640 PECOS PAC ID: 4486000379 Enrollment ID: I20231030000732 |
| Provider Name | Margaret Hinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033718713 PECOS PAC ID: 5092166470 Enrollment ID: I20240110002092 |
| Provider Name | Melonie Grantham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184793549 PECOS PAC ID: 8426409616 Enrollment ID: I20240112000060 |
| Provider Name | Marcus Stone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497878946 PECOS PAC ID: 7911358106 Enrollment ID: I20240112000248 |
| Provider Name | Felicia S Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629507322 PECOS PAC ID: 5597109470 Enrollment ID: I20240219003438 |
| Provider Name | Lourdes Damasco Tepper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174704191 PECOS PAC ID: 6406290030 Enrollment ID: I20240222000109 |
| Provider Name | Angela Inetta Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881069532 PECOS PAC ID: 7719322189 Enrollment ID: I20240226003249 |
| Provider Name | Anesha L Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043977887 PECOS PAC ID: 0648617944 Enrollment ID: I20240322000071 |
| Provider Name | Phoebee P Sharpe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043844145 PECOS PAC ID: 3971940206 Enrollment ID: I20240322001069 |
| Provider Name | Elasha Lavone Leary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699119420 PECOS PAC ID: 7911345376 Enrollment ID: I20240425003674 |
| Provider Name | Yuliet Sanchez-rivero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033479860 PECOS PAC ID: 6103060397 Enrollment ID: I20240515001758 |
| Provider Name | Adrianne Galassie Dietz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962887174 PECOS PAC ID: 8729420419 Enrollment ID: I20240528000122 |
| Provider Name | Shnita M Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912075326 PECOS PAC ID: 3476991423 Enrollment ID: I20240530004291 |
Marlboro Women's Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Marlboro Way, Suite 8, Bennettsville, SC 29512 Phone: 843-454-1100 Fax: 843-454-0110 | |
Marlboro Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Marlboro Way, Suite 1, Bennettsville, SC 29512 Phone: 843-479-5890 Fax: 843-479-5893 | |
Caresouth Carolina, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 999 Cheraw St, Bennettsville, SC 29512 Phone: 843-479-2341 | |
Mcleod Primary Care Bennettsville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Marlboro Way, Suite 1, Bennettsville, SC 29512 Phone: 843-479-5890 Fax: 843-479-3524 | |
Mcleod Pediatrics Bennettsville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1076 Marlboro Way Ste 3, Bennettsville, SC 29512 Phone: 843-479-0432 | |
Marlboro Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Marlboro Way, Suite 1, Bennettsville, SC 29512 Phone: 843-479-5890 Fax: 843-479-5893 |