| Continuum Physician Management Llc | |
|
1188 Stonecrest Blvd Ste 110 Fort Mill SC 29708-6633 | |
| (803) 616-3171 | |
| Not Available |
| Full Name | Continuum Physician Management Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1188 Stonecrest Blvd Ste 110, Fort Mill, South Carolina |
| Authorized Official Name and Position | George Boykin (CEO) |
| Authorized Official Contact | 8036163171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Continuum Physician Management Llc 1188 Stonecrest Blvd Ste 110 Fort Mill SC 29708-6633 Ph: (803) 616-3171 | Continuum Physician Management Llc 1188 Stonecrest Blvd Ste 110 Fort Mill SC 29708-6633 Ph: (803) 616-3171 |
| NPI Number | 1558191585 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 04/23/2025 |
| Certification Date | 04/23/2025 |
| Medicare PECOS PAC ID | 6002346129 |
|---|---|
| Medicare Enrollment ID | O20250205000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558191585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Laurie H Wybenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154512382 PECOS PAC ID: 1951473222 Enrollment ID: I20080701000410 |
| Provider Name | Brian P Mika |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073675799 PECOS PAC ID: 7214025766 Enrollment ID: I20100813000152 |
| Provider Name | Preetinder Ps Brar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851445209 PECOS PAC ID: 9133270853 Enrollment ID: I20140929001259 |
| Provider Name | Michele L Reina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417430984 PECOS PAC ID: 7113270794 Enrollment ID: I20181029001664 |
| Provider Name | Rebekah Shan Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144826975 PECOS PAC ID: 7416366448 Enrollment ID: I20210504001929 |
| Provider Name | Sushma Gunturu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861723215 PECOS PAC ID: 9537398524 Enrollment ID: I20220127003039 |
| Provider Name | Lauren Elisabeth Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841835212 PECOS PAC ID: 3274903455 Enrollment ID: I20230104001502 |
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