National Provider Identifier Database

NEXTPHASEMD
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

NEXTPHASEMD
107 W COLLEGE AVE
HARTSVILLE, SC29550-4113
Phone: 843-861-2726
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for NEXTPHASEMD

NPI Number 1225492168
Legal business name
LBN
NEXTPHASEMD
Authorized official MICHELLE QUAYE - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/06/2016
Last updated 04/06/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • SC License #: 22891
  • SC Medicaid: 228916
  • SC Other: SC 2958B578 PTAN
  • SC Other: 22891 SC STATE LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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