EDGEWATER MEDICAL CENTER (NPI# 1184878423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184878423 |
| Entity Type | Organization |
| Organization Name | EDGEWATER MEDICAL CENTER |
| Practice Address |
1162 Fort Mill Hwy Suite A Fort Mill SC 29707-7511 |
| Practice Telephone | 8033967900 |
| Practice Fax Number | 8033962963 |
| Mailing Telephone | 8033967900 |
| Mailing Fax Number | 8033962963 |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |
| Authorized Official Name | DR. BRIAN A WALKER (PHYSICIAN/PARTNER) |
| Authorized Official Telephone | 8033967900 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1162 FORT MILL HWY SUITE A |
| City | FORT MILL |
| State | SC |
| Zip Code | 29707-7511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649784521 | Chelsey Elizabeth Durham | Occupational Therapist | 1162 Fort Mill Hwy, Fort Mill, SC 29707 | 2017-11-29 |
| 1518403682 | Haley Long | Physical Therapist | 1162 Fort Mill Hwy, Fort Mill, SC 29707-7697 | 2017-01-13 |
| 1447706395 | Kelsey Zarek | Occupational Therapist | 1162 Fort Mill Hwy, Fort Mill, SC 29707-7697 | 2016-08-31 |
| 1306091301 | Edgewater Urgent Care | Family Medicine | 1162 Fort Mill Hwy, Suite A, Fort Mill, SC 29707-7511 | 2008-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535844 | Anomaly Bodywork & Wellness Center, LLC | Massage Therapist | 4068 Flats Main Street, Apt 100, Indian Land, SC 29707 | 2020-10-15 |
| 1164034369 | Renu Kapoor Virdi | Dentist | 9709 Redstone Dr, Ste 500, Indian Land, SC 29707 | 2020-08-19 |
| 1205467420 | Brian Keith Sutton | Physical Therapist | 2021 Bridgemill Dr, Ste 106, Indian Land, SC 29707 | 2020-01-27 |
| 1215575774 | Doby's Bridge Dentistry | Dentist | 4174 Dobys Brige Road Ste 100, Indian Land, SC 29707 | 2019-12-16 |
| 1346895141 | Redstone Modern Dentistry, PC | Dentist | 9709 Redstone Dr., Suite 500, Indian Land, SC 29707 | 2019-08-08 |
| 1396228698 | Daniel Allen | Massage Therapist | 4068 Flats Main St, Apt 100, Indian Land, SC 29707 | 2018-09-12 |
| 1598269409 | Dawn K Beatty-batten | Occupational Therapy Assistant | The Blake At Edgewater, 1099 Edgewater Corporate Parkway, Indian Land, SC 29707 | 2018-03-23 |
| 1366940959 | Kds Consultants, LLC | Family Medicine | 8351 Charlotte Hwy Ste 200, Indian Land, SC 29707 | 2018-01-29 |
| 1093227464 | Ivision Associates LLC | Optometrist | 9700 Red Stone Drive Suite 300, Indian Land, SC 29707 | 2017-10-25 |
| 1396274742 | Carson Tyler Mcginn | Specialist/Technologist | 8690 Henry Harris Rd., Fort Mill, SC 29707 | 2017-06-08 |
| Find all providers in zip 29707 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639542699 | Affinity Health Center | Family Medicine | 120 Elliott St E, Fort Mill, SC 29715-1848 | 2015-11-12 |
| 1932336542 | Smitha M Ballyamanda | Family Medicine | 515 Rivercrossing Dr, Suite 180, Fort Mill, SC 29715-7900 | 2009-06-22 |
| 1942409651 | Katrina Herring | Family Medicine | 773 Stockbridge Dr, Fort Mill, SC 29708-7200 | 2007-07-12 |
| 1558462085 | Arnold B Campo | Family Medicine | 377 Rubin Center Dr, Suite 110, Fort Mill, SC 29708-7275 | 2006-09-26 |
| 1407863343 | Piedmont Family Practice At Tega Cay, LLC | Family Medicine | 773 Stockbridge Drive, Fort Mill, SC 29708 | 2006-08-02 |
| 1144288796 | David M Mobley | Family Medicine | 502 6th Baxter Crossing, Fort Mill, SC 29708 | 2006-05-03 |
| 1811962574 | James C Jordan | Family Medicine | 1690 Highway 160 W, Fort Mill, SC 29708-8024 | 2006-02-17 |
| 1114999737 | Lance M Gowen | Family Medicine | 515 Rivercrossing Dr Ste 180, Fort Mill, SC 29715-7900 | 2006-02-07 |
| 1760462311 | Jennifer C Dickens | Family Medicine | 113 Millwood Dr, Fort Mill, SC 29715-8356 | 2006-01-19 |
| 1043819535 | Carolinas Physicians Network Inc | Family Medicine | 9623 Redstone Dr Ste 300, Fort Mill, SC 29707-5407 | 2020-10-26 |
| Find all providers in FORT MILL | ||||
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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.