KINGSTON FAMILY CARE (NPI# 1336128412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336128412 |
| Entity Type | Organization |
| Organization Name | KINGSTON FAMILY CARE |
| Practice Address |
1511 B 9th Ave Conway SC 29526-4107 |
| Mailing Address |
Box 106 4728 Jenn Dr Myrtle Beach SC 29577-5714 |
| Practice Telephone | 8438399202 |
| Mailing Telephone | 8438399202 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2007-10-26 |
| Authorized Official Name | CHARLOTTE L SLOAN (OWNER) |
| Authorized Official Telephone | 8438399202 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
26916 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4278 | 05 |
| Street Address |
1511 B 9TH AVE |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386143717 | Andrew Freeman Oliver | Nurse Practitioner | 650 United Dr Ste 200, Conway, AR 72032-7001 | 2018-02-12 |
| 1255851515 | Brett Alan Morris | Nurse Practitioner | 1555 Exchange Ave, Conway, AR 72032-7824 | 2017-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588819 | Natalia Milliken | Nurse Practitioner | 4921 Bluffton Pkwy Apt 534, Bluffton, SC 29910-4655 | 2020-11-04 |
| 1447851084 | Paris Gartmon | Nurse Practitioner | 630 Canalside St Unit 1016, Columbia, SC 29201-6030 | 2020-11-02 |
| 1881291722 | Margot Veronique Rabren | Nurse Practitioner | 109 Carter Park Dr # 3a, Seneca, SC 29678-1152 | 2020-10-05 |
| 1134736309 | Holly Leanne Poplin | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite C, Main Street Physicians/sc House Calls Inc, Little River, SC 29566 | 2020-09-30 |
| 1821649344 | Jacqueline G. Stephens | Nurse Practitioner | 406 S Railroad Ave, Lamar, SC 29069-2906 | 2019-09-25 |
| 1780241182 | Adrienne Lendsey Hinton | Nurse Practitioner | 201 Lake Front Dr, Columbia, SC 29212-2422 | 2019-05-22 |
| 1083278279 | Heather Michelle Martin | Nurse Practitioner | 115 Eagles Nest Dr Ste B, Seneca, SC 29678-2762 | 2019-04-24 |
| 1871055210 | Kelli Lane Evans | Nurse Practitioner | 260 W Coleman Blvd Ste A, Mount Pleasant, SC 29464-3666 | 2019-04-04 |
| 1255807087 | Jaclyn Blair Lucchese | Nurse Practitioner | 25 Hospital Center Blvd Ste 105, Hilton Head Island, SC 29926-2735 | 2018-10-19 |
| 1790297497 | Juliann Marie Trumpower | Nurse Practitioner | 9789 Charlotte Hwy Ste 1400, Fort Mill, SC 29707-7186 | 2017-11-02 |
| Find all providers with the same taxonomy | ||||
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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.