| Caromont Family Medicine | |
|
519 Nautical Dr Ste 100a Clover SC 29710-8113 | |
| (803) 631-2858 | |
| (803) 631-2862 |
| Full Name | Caromont Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 519 Nautical Dr Ste 100a, Clover, South Carolina |
| Authorized Official Name and Position | David Michael Oconnor (CFO) |
| Authorized Official Contact | 7046715343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caromont Family Medicine Po Box 744786 Atlanta GA 30374-4786 Ph: (704) 834-2450 | Caromont Family Medicine 519 Nautical Dr Ste 100a Clover SC 29710-8113 Ph: (803) 631-2858 |
| NPI Number | 1568641165 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 08/17/2023 |
| Medicare PECOS PAC ID | 3577476258 |
|---|---|
| Medicare Enrollment ID | O20041021000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568641165 | NPI | - | NPPES |
| 890267Q | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jonathan Jay Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639103039 PECOS PAC ID: 0143239301 Enrollment ID: I20060417000333 |
| Provider Name | Pamela B Pritchett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487641007 PECOS PAC ID: 2365334679 Enrollment ID: I20120123000724 |
| Provider Name | Amanda Chamelle Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770970873 PECOS PAC ID: 9234434143 Enrollment ID: I20160301001299 |
| Provider Name | Kofi Asiedu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912374166 PECOS PAC ID: 6002108933 Enrollment ID: I20160713000634 |
| Provider Name | Larry Jw Skeete |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508854407 PECOS PAC ID: 4981684313 Enrollment ID: I20161031001751 |
| Provider Name | Nonna K Weinstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619219169 PECOS PAC ID: 7416187919 Enrollment ID: I20161220000272 |
| Provider Name | Cheryl D Gunther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639499411 PECOS PAC ID: 6204010341 Enrollment ID: I20170203000137 |
| Provider Name | Patricia Shannon Hopson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1508852252 PECOS PAC ID: 0446220834 Enrollment ID: I20181003003437 |
| Provider Name | Catherine M Fletchall Belle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891099925 PECOS PAC ID: 5991942997 Enrollment ID: I20190409003131 |
| Provider Name | Kani Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073047379 PECOS PAC ID: 7911262431 Enrollment ID: I20190820003462 |
| Provider Name | James Mitchell Costner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841257540 PECOS PAC ID: 5294893871 Enrollment ID: I20200319001722 |
| Provider Name | Holly Layne Faux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891325593 PECOS PAC ID: 5395173751 Enrollment ID: I20210311002399 |
| Provider Name | Alvina Elaine Scaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477036556 PECOS PAC ID: 6507110855 Enrollment ID: I20210430001511 |
| Provider Name | Andrew E Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417935024 PECOS PAC ID: 2961644976 Enrollment ID: I20210909003767 |
| Provider Name | Elliott Bradley Courter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558744359 PECOS PAC ID: 9931417755 Enrollment ID: I20210923001931 |
| Provider Name | Ravali Nallu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477908341 PECOS PAC ID: 7315231230 Enrollment ID: I20211209002073 |
| Provider Name | Kelly A Hoyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316428618 PECOS PAC ID: 1153665633 Enrollment ID: I20220125002185 |
| Provider Name | Crystal Cornelia Maddox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942520937 PECOS PAC ID: 0749438018 Enrollment ID: I20220615002946 |
| Provider Name | Tonya C Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255009049 PECOS PAC ID: 0941699565 Enrollment ID: I20220810003171 |
| Provider Name | Amanda L Mattox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831768159 PECOS PAC ID: 1658776208 Enrollment ID: I20220929003941 |
| Provider Name | Hallie K Gunst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982348868 PECOS PAC ID: 4789060542 Enrollment ID: I20221005002723 |
| Provider Name | Dustin Lee Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902416258 PECOS PAC ID: 5294148649 Enrollment ID: I20221012002990 |
| Provider Name | Amber S Sipe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487088696 PECOS PAC ID: 0749417210 Enrollment ID: I20221031003127 |
| Provider Name | Marty A Baker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730103953 PECOS PAC ID: 2264426717 Enrollment ID: I20230905003960 |
| Provider Name | Loverica F Irby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588044002 PECOS PAC ID: 8426344409 Enrollment ID: I20230905003987 |
| Provider Name | Beni Mfitidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538796503 PECOS PAC ID: 7618391426 Enrollment ID: I20231003003646 |
| Provider Name | Edward L Held |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295350494 PECOS PAC ID: 0941623524 Enrollment ID: I20231006002963 |
| Provider Name | Katisha M Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821700329 PECOS PAC ID: 2264804954 Enrollment ID: I20240117004535 |
Affinity Health Center Clover Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Clinton Ave, Clover, SC 29710 Phone: 803-909-6363 | |
Clover Chiropractic Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 S Main St, Clover, SC 29710 Phone: 803-222-2561 | |
Clover Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3420 Filbert Hwy, Clover, SC 29710 Phone: 803-222-0600 Fax: 803-222-6119 | |
Novant Health Family Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 Church St, Clover, SC 29710 Phone: 803-222-3063 Fax: 803-222-3064 | |
Southern Clinic And Urgt Car Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3420 Filbert Hwy, Clover, SC 29710 Phone: 803-222-0600 Fax: 803-222-6119 |