HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
NPI 1417570771
Family Medicine - Hospice and Palliative Medicine in Fort Mill, SC
- Organization
- Family Medicine
- Hospice and Palliative Medicine
- Accepts Insurance
- CLIA Number: 34D1076168
- CLIA Cert. Type: Hospice
- CLIA Exp. Date: 11-06-2027
About HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
This page provides the complete NPI Profile along with additional information for Hospice & Palliative Care Charlotte Region, a provider established in Fort Mill, South Carolina operating as a Family Medicine, focusing in hospice and palliative medicine . The healthcare provider is registered in the NPI registry with number 1417570771 assigned on May 2020. The practitioner's primary taxonomy code is 207QH0002X. The provider is registered as an organization and their NPI record was last updated one year ago. Hospice & Palliative Care Charlotte Region operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Peter A Brunnick (President/ Ceo)
- NPI
- 1417570771 Verify this NPI
- Provider Name
- HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1061 RED VENTURES DR STE 130 FORT MILL, SC 29707
- Location Phone
- (803) 548-3708
- Location Fax
- (803) 431-2249
- Mailing Address
- PO BOX 470408 CHARLOTTE, NC 28247
- Mailing Phone
- (704) 375-0100
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-21-2020
- Last Update Date
- 04-24-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Hospice and Palliative Medicine
- Taxonomy Code
- 207QH0002X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Direction Bronze 1 - POS
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Expanded Bronze - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- BlueEssentials Gold 1 - EPO
- BlueEssentials Gold 5 - EPO
- BlueEssentials Silver 14 - EPO
- BlueEssentials Silver 14 + Adult Vision - EPO
- BlueEssentials Silver 40 - EPO
- BlueEssentials Standard Expanded Bronze - EPO
- BlueEssentials Standard Gold - EPO
- BlueEssentials Standard Silver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| PG2392 | MEDICAID (05) | SC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D1076168
- Facility Type
- Hospice
- Certificate Effective Date
- November 07, 2025
- Certificate Expiration Date
- November 06, 2027
- Laboratory Director
- ROBERT SMITH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Hospice & Palliative Care Charlotte Region to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
FORT MILL, SC 29707
FORT MILL, SC 29707
FORT MILL, SC 29707
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417570771, enumerated as an "organization" on May 21, 2020.
The provider is located at 1061 RED VENTURES DR STE 130 FORT MILL, SC 29707 and the phone number is (803) 548-3708.
Family Medicine with taxonomy code 207QH0002X and a focus in Hospice and Palliative Medicine.
The provider might be accepting Accepts: BlueCross BlueShield of South Carolina, Medicare. Please consult your insurance carrier or call the provider to verify.
