| Community Medicine Foundation | |
|
1131 Saluda St Rock Hill SC 29730-5776 | |
| (803) 325-7744 | |
| Not Available |
| Full Name | Community Medicine Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1131 Saluda St, Rock Hill, South Carolina |
| Authorized Official Name and Position | Ernest G. Brown (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8033257744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medicine Foundation Po Box 28 Rock Hill SC 29731-6028 Ph: (803) 325-7744 | Community Medicine Foundation 1131 Saluda St Rock Hill SC 29730-5776 Ph: (803) 325-7744 |
| NPI Number | 1528004918 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 4880687490 |
|---|---|
| Medicare Enrollment ID | O20040407001159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528004918 | NPI | - | NPPES |
| FQC025 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Roosevelt Daniel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275571846 PECOS PAC ID: 7810932498 Enrollment ID: I20050623000731 |
| Provider Name | Paula D Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831409812 PECOS PAC ID: 0446434690 Enrollment ID: I20110412000802 |
| Provider Name | Xaviera M Carter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275769465 PECOS PAC ID: 0840434395 Enrollment ID: I20130924000002 |
| Provider Name | Jutta Lynn Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790100063 PECOS PAC ID: 6800018078 Enrollment ID: I20141104001889 |
| Provider Name | Shervon A Pierre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477781995 PECOS PAC ID: 5395984058 Enrollment ID: I20161018000147 |
| Provider Name | Charita M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942752076 PECOS PAC ID: 1052693280 Enrollment ID: I20170124002197 |
| Provider Name | Jacquelyn Suzanne Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194145615 PECOS PAC ID: 3779704010 Enrollment ID: I20171024003274 |
| Provider Name | Treneice C London |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114375300 PECOS PAC ID: 0648564633 Enrollment ID: I20181108000828 |
| Provider Name | Elijah Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992317366 PECOS PAC ID: 5496168569 Enrollment ID: I20210108002478 |
| Provider Name | Monique Stafford |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194447250 PECOS PAC ID: 0042687139 Enrollment ID: I20221102001497 |
| Provider Name | Veleka Mayfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750001921 PECOS PAC ID: 3577933720 Enrollment ID: I20230104000287 |
| Provider Name | Vernette Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073982757 PECOS PAC ID: 5395183966 Enrollment ID: I20240402000333 |
| Provider Name | Alyse Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811777105 PECOS PAC ID: 2961841911 Enrollment ID: I20240423004033 |
| Provider Name | Brittney Congdon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871857896 PECOS PAC ID: 7315388717 Enrollment ID: I20240516001757 |
| Provider Name | Jovan Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922820497 PECOS PAC ID: 7416487269 Enrollment ID: I20250207002357 |
| Provider Name | Joyce Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174383236 PECOS PAC ID: 9436677481 Enrollment ID: I20250514001604 |
Carolinas Physicians Network Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1656 Riverchase Blvd, Ste 1800, Rock Hill, SC 29732 Phone: 803-909-1850 | |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 382 Workman St, Rock Hill, SC 29730 Phone: 803-325-7710 | |
Carolinas Physicians Network Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1656 Riverchase Blvd, Ste 2400, Rock Hill, SC 29732 Phone: 803-329-5131 | |
Community Medicine Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont Blvd. Suite 100, Catawba Community Mental Health Services York Adult Ser, Rock Hill, SC 29732 Phone: 803-327-2012 Fax: 803-325-7744 | |
Carolinas Physicians Network Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 757 Anderson Rd S, Rock Hill, SC 29730 Phone: 803-326-3790 | |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |
Shiland Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1656 Riverchase Blvd, Suite 2400, Rock Hill, SC 29732 Phone: 803-329-5131 |