MIRIAM MEDICAL CLINIC LLC
NPI 1487361127
Nurse Practitioner - Family in Rock Hill, SC
About Miriam Medical Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIRIAM MEDICAL CLINIC LLC (NPI 1487361127) is a healthcare organization registered as a family in Rock Hill, South Carolina and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through February 6, 2027 and lists Marie Fenelon, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Miriam Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Miriam Medical Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 42D2276298
Miriam Medical Clinic, LLC · Rock Hill, SCFrequently 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 Miriam Medical Clinic LLC's NPI number?
The NPI number for Miriam Medical Clinic LLC is 1487361127. It was assigned to this organization in the NPPES registry on November 2, 2022.
Where is Miriam Medical Clinic LLC located?
Miriam Medical Clinic LLC is located at 1926 India Hook Rd, Rock Hill, SC 29732. The listed phone number is (704) 904-3367.
What is Miriam Medical Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Miriam Medical Clinic LLC enrolled in Medicare?
Yes. Miriam Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Miriam Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Miriam Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Miriam Medical Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2276298) is associated with this NPI, valid through February 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Miriam Medical Clinic LLC accept?
Health plans from BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Miriam Medical Clinic LLC 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 Miriam Medical Clinic LLC was last updated on November 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Miriam Medical Clinic Llc · NPI 1487361127
Family organization in Rock Hill, South Carolina. Organization record, active in the CMS NPPES registry since November 2, 2022.
## Identity
- **NPI:** 1487361127 (Entity type: Organization)
- **Enumerated:** November 2, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Marie Fenelon, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 1926 INDIA HOOK RD, Rock Hill, SC 29732-1218
- **Phone:** (704) 904-3367
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 2, 2022
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1487361127) · Data from the CMS NPPES public registry.