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EDISTO INDIAN FREE CLINIC
NPI 1407250566
Clinic/Center in Ridgeville, SC

Active since October 20, 2014CLIA 42D2129503 · Waiver
1125 RIDGE RD, RIDGEVILLE, SC 29472(843) 871-2126(843) 832-6019 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jun 20, 2018 (2 updates tracked since 2018).

About Edisto Indian Free Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDISTO INDIAN FREE CLINIC (NPI 1407250566) is a healthcare organization registered as a clinic/center in Ridgeville, South Carolina and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through April 19, 2027 and lists Donnie Creel, Chairman Of The Board, as its authorized official.

NPPES Registry Identity

NPI1407250566
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameFOUR HOLES INDIAN ORGANIZATION EDISTO TRIBAL INC.
Location Address1125 RIDGE RDRidgeville, SC 29472-7846
Mailing Address1125 Ridge RdRidgeville, SC 29472-7846 · (843) 871-2126 · Fax (843) 832-6019
Phone(843) 871-2126
Fax(843) 832-6019
Organization SubpartNo
Authorized OfficialDonnie CreelChairman Of The Board · (843) 871-2126
Enumeration DateOctober 20, 2014
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1407250566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1125 RIDGE RD, Ridgeville, SC 29472
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Other Names 1

Doing Business AsEdisto Indian Free Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2129503

Edisto Indian Free Clinic · Ridgeville, SC
Active · expires Apr 19, 2027
CLIA Number42D2129503
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 20, 2025
Certificate Expiration DateApril 19, 2027
Laboratory DirectorKristen A. Myers
Laboratory Phone(843) 871-2126
Laboratory LocationEdisto Indian Free Clinic1125 Ridge Rd, Ridgeville, SC 29472
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Four Holes Indian Organization Edisto Tribal Inc.'s NPI number?

The NPI number for Four Holes Indian Organization Edisto Tribal Inc. is 1407250566. It was assigned to this organization in the NPPES registry on October 20, 2014. The provider is doing business as Edisto Indian Free Clinic.

Where is Four Holes Indian Organization Edisto Tribal Inc. located?

Four Holes Indian Organization Edisto Tribal Inc. is located at 1125 Ridge Rd, Ridgeville, SC 29472. The listed phone number is (843) 871-2126.

What is Four Holes Indian Organization Edisto Tribal Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Four Holes Indian Organization Edisto Tribal Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2129503) is associated with this NPI, valid through April 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Four Holes Indian Organization Edisto Tribal Inc. accept?

Health plans from First Choice Next list Four Holes Indian Organization Edisto Tribal Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Four Holes Indian Organization Edisto Tribal Inc. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.