MIRIAM MEDICAL CLINIC LLC
NPI 1487361127
Nurse Practitioner - Family in Rock Hill, SC

Active since November 02, 2022CLIA 42D2276298 · Waiver
1926 INDIA HOOK RD, ROCK HILL, SC 29732(704) 904-3367 Get Directions Write a Review

NPPES record last updated: November 2, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1487361127
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameMIRIAM MEDICAL CLINIC LLC
Location Address1926 INDIA HOOK RDRock Hill, SC 29732-1218
Mailing Address1926 India Hook RdRock Hill, SC 29732-1218 · (704) 904-3367
Organization SubpartNo
Authorized OfficialMarie FenelonAuthorized Official · (704) 904-3367
Enumeration DateNovember 2, 2022
NPPES CertifiedNovember 2, 2022
NPI 1487361127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1926 INDIA HOOK RD, Rock Hill, SC 29732

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted 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 42D2276298

Miriam Medical Clinic, LLC · Rock Hill, SC
Active · expires Feb 6, 2027
CLIA Number42D2276298
Laboratory TypeCommunity Clinic
Certificate Effective DateFebruary 7, 2025
Certificate Expiration DateFebruary 6, 2027
Laboratory DirectorMarie M. Fenelon
Laboratory Phone(803) 366-4206
Laboratory LocationMiriam Medical Clinic, LLC1926 India Hook Road, Rock Hill, SC 29732
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1926 INDIA HOOK RD
ROCK HILL, SC 29732

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 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.

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 Ambetter from Absolute Total Care, Ambetter of North 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.