PRIMECARE HEALTH CENTER PA (NPI# 1659446219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659446219 |
| Entity Type | Organization |
| Organization Name | PRIMECARE HEALTH CENTER PA |
| Practice Address |
1055 Ribaut Rd Suite 10 Beaufort SC 29902-5423 |
| Mailing Address |
27 Kemmerlin Lane Beaufort SC 29907-2702 |
| Practice Telephone | 8435242100 |
| Practice Fax Number | 8435259613 |
| Mailing Telephone | 8435242100 |
| Mailing Fax Number | 8435259613 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | GINA Y POPE (OWNER) |
| Authorized Official Telephone | 8435242100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 24049 | SC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SC MEDICAL LICENSE # | 24049 | 01 |
| Street Address |
1055 RIBAUT RD SUITE 10 |
| City | BEAUFORT |
| State | SC |
| Zip Code | 29902-5423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750385274 | Internal Medicine Healthcare, P.a. | Internal Medicine | 1055 Ribaut Rd, Ste 10, Beaufort, SC 29902-3402 | 2005-06-13 |
| 1962948679 | Cameron Paige Price | Physician Assistant | 1055 Ribaut Rd, Suite 30, Beaufort, SC 29902-5423 | 2017-01-19 |
| 1972906626 | Nancy Elizabeth Thomas | Physician Assistant | 1055 Ribaut Rd, Beaufort, SC 29902-5423 | 2014-10-08 |
| 1528101664 | Coastal Carolina Urology Group, LLC | Urology | 1055 Ribaut Rd, Suite 10, Beaufort, SC 29902-5423 | 2007-02-15 |
| 1477612703 | Coastal Carolina Urology Group LLC | Urology | 1055 Ribaut Rd, Suite 10, Beaufort, SC 29902-5423 | 2006-12-06 |
| 1013081678 | John B Adams II | Urology | 1055 Ribaut Rd, Suite 10, Beaufort, SC 29902-5423 | 2006-11-17 |
| 1881768430 | Louis F Plzak IIi | Urology | 1055 Ribaut Rd, Suite 10, Beaufort, SC 29902-5423 | 2006-11-17 |
| 1821062423 | Gordon E Krueger | Surgery | 1055 Ribaut Rd, Ste 30, Beaufort, SC 29902-5447 | 2006-02-13 |
| 1538132931 | James Chadwick Tober | Surgery | 1055 Ribaut Rd, Ste 30, Beaufort, SC 29902-5447 | 2006-02-08 |
| 1811960214 | Ronald S Wise | Surgery | 1055 Ribaut Rd, Ste 30, Beaufort, SC 29902-5447 | 2006-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1750992475 | Fayth Polite | Social Worker | 2210 Salem Drive East, Beaufort, SC 29902 | 2020-08-14 |
| 1417509530 | Andrew Grant Miner | Dentist | Naval Hospital Beaufort, 1 Pinckney Blvd., Fpo, AA 29902 | 2019-07-09 |
| 1376029777 | Edward Dela Fuente | Counselor | Coastal Empire Mental Health Center, 1050 Ribaut Road, Beaufort, SC 29902 | 2018-07-18 |
| 1114440419 | Kristin Webb | Registered Nurse | 607 Wilmington Street, Beaufort, SC 29902 | 2017-07-19 |
| 1326582081 | Annemarie Gierling Gault | Nurse Practitioner | Beaufort Memorial Medical Oncology Infusion Center, 989 Ribaut Rd, Ste 103, Beaufort, SC 29902 | 2016-12-14 |
| 1114396579 | Jacquelyn Faith Proulx | Dentist | 1 Pickney Blvd., Naval Hospital Beaufort, Beaufort, SC 29902 | 2015-09-16 |
| 1386028413 | Howard Family Dental - Beaufort, Pllc | Dentist | 35 Robert Smalls Pkwy, Beaufort, SC 29902 | 2015-07-18 |
| 1598018103 | Lisa Marie Johnson | Occupational Therapist | 9555 Ribaut Road, Beaufort Memorial Hospital, Beaufort, SC 29902 | 2012-10-19 |
| 1134497860 | Jeremy Michael Simmons | Pharmacist | 2127 Boundary Street, Suite 19, Beaufort, SC 29902 | 2011-12-08 |
| Find all providers in zip 29902 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801217831 | Shardae Bartley | Specialist | 301 Carteret St, Beaufort, SC 29902-5525 | 2013-12-17 |
| 1619248317 | Beaufort County Memorial Hospital | Specialist | 990 Ribaut Rd Ste 210, Beaufort, SC 29902-8011 | 2012-01-26 |
| 1336462894 | Cynthia Allison-simpkins | Specialist | 90 Marsh Dr, Beaufort, SC 29907-1354 | 2010-03-11 |
| 1346474996 | Beaufort County Memorial Hospital | Specialist | Beaufort Memorial Surgical Specialists, 989 Ribaut Rd, Ste 360, Beaufort, SC 29902-5427 | 2009-05-12 |
| 1417008459 | Beaufort Gastroenterology | Specialist | 989 Ribaut Rd Ste 300, Beaufort, SC 29902-5426 | 2007-01-16 |
| 1477618189 | Coastal Obstetrics and Gynecology | Specialist | 13 Marshellen Drive, Beaufort, SC 29902 | 2006-12-22 |
| 1275618332 | Palmetto Pain Center Pa | Specialist | 41 Marshellen Dr, Suite A, Beaufort, SC 29902-6900 | 2006-10-26 |
| 1154365575 | Evan C Reese Jr. | Specialist | 1251 B Ribaut Rd, Beaufort, SC 29902 | 2006-06-15 |
| 1285673327 | James A Swenson | Specialist | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-06-05 |
| 1205888765 | Karen Michelle Eller | Specialist | 41a Marshellen Dr, Palmetto Pain Pa, Beaufort, SC 29902-6900 | 2006-05-16 |
| Find all providers in BEAUFORT | ||||
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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.