LORIS MEDICAL CENTER, PA (NPI# 1740216191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740216191 |
| Entity Type | Organization |
| Organization Name | LORIS MEDICAL CENTER, PA |
| Practice Address |
3439 Casey St Loris SC 29569-2903 |
| Practice Telephone | 8437561582 |
| Practice Fax Number | 8437562042 |
| Mailing Telephone | 8437565300 |
| Mailing Fax Number | 8437566059 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2009-09-10 |
| Authorized Official Name | MRS. WANDA GRAHAM (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8437565300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PALMETTO MEDICARE | 4771 | 01 |
| NC | 5950200 | 05 | |
| NC | NORTH CAROLINA BCBS | 0291J | 01 |
| SC | RAILROAD MEDICARE | CA6664 | 01 |
| SC | GP1053 | 05 |
| Street Address |
3439 CASEY ST |
| City | LORIS |
| State | SC |
| Zip Code | 29569-2903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245725027 | Susan Cook | Specialist | 3439 Casey St, Loris, SC 29569-2903 | 2018-06-25 |
| 1235583378 | Behavior Balance, LLC | Counselor | 3439 Casey St, Loris, SC 29569 | 2016-04-14 |
| 1093886277 | Howard Calhoun | Counselor | 3439 Casey St, Loris, SC 29569 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427464247 | Denise Logan | Dietitian, Registered | 3811 Walnut St, Loris, SC 29569 | 2014-07-02 |
| 1801231634 | Melissa Ann Miara | Internal Medicine | 3617 Casey St Ste C, Loris, SC 29569 | 2013-05-07 |
| 1356684161 | Gwyn Gordon Mcgutchen | Dentist | 3681 Spivey St., Loris, SC 29569 | 2013-03-29 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1528314325 | Southern Living Emergency Physicians LLC | Physician Assistant | 6988 Mitchell Street, Loris, SC 29569 | 2012-07-30 |
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1700911203 | Twin States Helping Hands | Home Health | 1620 Hwy 701 N, Loris, SC 29569 | 2007-02-23 |
| 1306922646 | Loris Community Hospital District | Clinic/Center | 3204 Casey St, Loris, SC 29569 | 2006-10-30 |
| 1619074119 | South Carolina Cvs Pharmacy LLC | Pharmacy | 4767 Broad St, Loris, SC 29569 | 2006-09-20 |
| Find all providers in zip 29569 | ||||
| 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 |
|---|---|---|---|---|
| 1619100096 | Little River Medical Center, Inc. | Family Medicine | 3817 Main St, Loris, SC 29569-3017 | 2009-09-01 |
| 1467441329 | James N Moore IIi | Family Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2005-10-13 |
| 1629480751 | Lyndsi Cress | Family Medicine | 3418 Casey St, Loris, SC 29569-2904 | 2014-05-23 |
| 1326303538 | Bernice Francesca Lim | Family Medicine | 3817 Main St, Loris, SC 29569-3017 | 2012-07-13 |
| 1043302060 | Southern Medical Associates, P.a. | Family Medicine | 3418 Casey St, Loris, SC 29569-2904 | 2006-09-28 |
| 1285726232 | Mark F Pelstring | Family Medicine | 3418 Casey St, Loris, SC 29569-2904 | 2006-09-28 |
| 1144311812 | Andrew J.r. Sejan | Family Medicine | 3418 Casey St, Loris, SC 29569 | 2006-09-27 |
| 1972694628 | Timothy C Mills | Family Medicine | 3418 Casey St, Loris, SC 29569 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495841 | Neuro Health Sc LLC | Family Medicine | 108 Commons Blvd Ste A, Piedmont, SC 29673-7766 | 2020-10-21 |
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1154928570 | Lexington Health Inc | Family Medicine | 146 E Hospital Dr Ste 500, West Columbia, SC 29169-4842 | 2020-10-08 |
| 1477150340 | Meghan Hodapp | Family Medicine | 623 Awendaw Lakes Blvd, Awendaw, SC 29429-6407 | 2020-10-05 |
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1851906267 | Avneet Nagra | Family Medicine | 162 Montauk Dr, Lexington, SC 29072-6776 | 2020-09-11 |
| 1134732753 | Ovp Health Care, Inc. | Family Medicine | 101 S Catawba St, Lancaster, SC 29720-2411 | 2020-08-24 |
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1841801149 | Palmetto Primary Care Physicians, LLC | Family Medicine | 1200 Two Island Ct Unit E, Mt Pleasant, SC 29466-7418 | 2020-08-11 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| 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.