HOPE CLINIC LLC (NPI# 1144299470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144299470 |
| Entity Type | Organization |
| Organization Name | HOPE CLINIC LLC |
| Other Organization Name | HOPE CLINIC LLC |
| Practice Address |
110 Executive Pkwy Moncks Corner SC 29461-3930 |
| Practice Telephone | 8438999099 |
| Practice Fax Number | 8883185567 |
| Mailing Telephone | 8434084171 |
| Mailing Fax Number | 8883185567 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2017-06-09 |
| Authorized Official Name | ASANTE WAGNER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8434084171 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 20234 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4225947 | 01 | |
| SC | GP3438 | 05 | |
| SC | 202346 | 05 |
| Other Name | Type Code |
|---|---|
| HOPE CLINIC LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205017860 | Hope Clinic LLC | Internal Medicine | 5880 Rivers Ave, North Charleston, SC 29406 | 2007-11-23 |
| Street Address |
110 EXECUTIVE PKWY |
| City | MONCKS CORNER |
| State | SC |
| Zip Code | 29461-3930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710986757 | Temisan L Etikerentse | Internal Medicine | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2005-07-20 |
| 1073064200 | Svetlana Stuck | Physician Assistant | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2016-10-24 |
| 1952699688 | Hope Clinic | Non-Pharmacy Dispensing Site | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2011-07-15 |
| 1932213378 | Fetter Health Care Network, Inc | Clinic/Center | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982267605 | Berkeley Citizens Inc | Early Intervention Provider Agency | P0 Drawer 429 1301 Old Hwy 52 South, Moncks Corner, SC 29461 | 2019-04-18 |
| 1376015222 | Anthony Johnson | Counselor | 306 Airport Drive, Moncks Corner, SC 29461 | 2018-12-17 |
| 1598243719 | Jana Matthews Chinners | Family Medicine | 2061 Us-52, Moncks Corner, SC 29461 | 2018-07-31 |
| 1285151225 | Nathan Andrew Bostrom | Occupational Therapist | 118 Carolina Avenue, Moncks Corner, SC 29461 | 2017-08-29 |
| 1942730528 | Martina Snider | Specialist | 393 Corner Square Plaza, Moncks Corner, SC 29461 | 2017-06-15 |
| 1104355502 | Mary Elizabeth Perdue | Counselor | 306 Airport Dr., Moncks Corner, SC 29461 | 2017-06-08 |
| 1619390481 | Berkeley Citizens, Inc. | Public Health or Welfare | 1301 Old Hwy. 52 South, Moncks Corner, SC 29461 | 2014-01-29 |
| 1326384082 | Amanda Trueworthy | Counselor | 3156 F South Live Oak Drive, Moncks Corner, SC 29461 | 2012-12-27 |
| 1790040202 | Melanie Mcendree | Community Health Worker | 105 Lobolly Dr., Moncks Corner, SC 29461 | 2012-07-10 |
| 1891093845 | Leslie Erin Blackmon Stelling | Pharmacist | 110 South Highway 52, Moncks Corner, SC 29461 | 2011-02-28 |
| Find all providers in zip 29461 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154514529 | Omolola Ajoke Omotoso | Internal Medicine | 110 Executive Parkway, Moncks Corner, SC 29461 | 2007-08-20 |
| 1710986757 | Temisan L Etikerentse | Internal Medicine | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2005-07-20 |
| 1932562493 | Roper Saint Francis Physicians Network | Internal Medicine | 730 Stony Landing Rd, Suite 200, Moncks Corner, SC 29461-2904 | 2016-04-01 |
| 1235368457 | Roper Saint Francis Physicians Network | Internal Medicine | 730 Stoney Landing Rd, Moncks Corner, SC 29461-2948 | 2009-07-09 |
| 1972746261 | Roper Saint Francis Physicians Network | Internal Medicine | 730 Stony Landing Rd, Suite 100, Moncks Corner, SC 29461 | 2009-04-16 |
| 1417137803 | Berkeley Medical Center, LLC | Internal Medicine | 106 W Main St, Moncks Corner, SC 29461-2601 | 2007-11-14 |
| 1548299159 | Rose Delores Gibbs | Internal Medicine | 106 W Main St, Moncks Corner, SC 29461 | 2006-07-03 |
| 1669424487 | Edward Johnson Jones IIi | Internal Medicine | 115 Executive Parkway, Moncks Corner, SC 29461 | 2006-05-17 |
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|---|---|---|---|---|
| 1932706280 | Lexington Health Inc | Internal Medicine | 146 E Hospital Dr Ste 530, West Columbia, SC 29169-4800 | 2020-10-08 |
| 1134746555 | Medical University Hospital Authority | Internal Medicine | 1205 North Main Street, Mullins, SC 29474 | 2020-07-01 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1700402849 | Michael Allan Goble | Internal Medicine | Internal Medical Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-24 |
| 1972128221 | John Fincher Gist Bobo | Internal Medicine | 169 Ashley Ave Rm 202muh, Charleston, SC 29425-8905 | 2020-06-12 |
| 1841829215 | Baird Medical, LLC | Internal Medicine | 65 Winston Cir, Pawleys Island, SC 29585-4841 | 2020-04-07 |
| 1104452770 | Marlo Bruno, LLC | Internal Medicine | 191 Preston Dr, Pawleys Island, SC 29585-6320 | 2020-03-16 |
| 1205469624 | Crocodile Pharmacy Services, LLC | Internal Medicine | 1731 Laurel St, Columbia, SC 29201-2624 | 2020-02-13 |
| 1053943555 | Rafael D Sanchez Medical Services LLC | Internal Medicine | 17 Field Sparrow Rd, Hilton Head Island, SC 29926-1812 | 2020-02-12 |
| 1952945636 | Jag Medical Services LLC | Internal Medicine | 105 S Cedar St Ste G, Summerville, SC 29483-6078 | 2019-11-05 |
| Find all providers with the same taxonomy | ||||
| City | MONCKS CORNER |
| Zip Code | 29461 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.