CAROLINA LONG TERM CARE ASSOICATESPC NPI 1417989229

NPI Information

  • NPI: 1417989229
  • Provider Name: CAROLINA LONG TERM CARE ASSOICATES,PC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 113 WILDWOOD DR
    BELTON, SC
    ZIP 29627
  • Phone: (864) 940-9701

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NPI Details

CAROLINA LONG TERM CARE ASSOICATES,PC is a general practice in Belton, SC. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CAROLINA LONG TERM CARE ASSOICATES,PC NPI is 1417989229. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

113 WILDWOOD DR
BELTON, SC
ZIP 29627-687
Phone: (864) 940-9701
Fax: (864) 338-8760

The provider's authorized official is Kenneth Bryan Heller .
The authorized official title is President and has the following contact phone number (864) 940-9701.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 9/16/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2363LF0000XNurse PractitionerFamilyNo
3208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17117MEDICARE PINSOUTH CAROLINA
2GP3289MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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