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BROAD RIVER WELLNESS, LLC
NPI 1992454532
Family Medicine in Sharon, SC

Active since March 21, 2022CLIA 42D2256433 · Waiver
4027 WOODLAWN ST, SHARON, SC 29742(803) 627-0220 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 17, 2024, Apr 25, 2022 (2 updates tracked since 2022).

About Broad River Wellness, Llc NPPES

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

BROAD RIVER WELLNESS, LLC (NPI 1992454532) is a healthcare organization registered as a family medicine in Sharon, South Carolina and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through March 23, 2028, maintains a secondary practice location in Clover, and lists Rebecca Baker, Owner, as its authorized official.

NPPES Registry Identity

NPI1992454532
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBROAD RIVER WELLNESS, LLC
Location Address4027 WOODLAWN STSharon, SC 29742-8779
Mailing Address4027 Woodlawn StSharon, SC 29742-8779 · (803) 658-5058 · Fax (803) 658-5035
Phone(803) 627-0220
Organization SubpartNo
Authorized OfficialRebecca BakerOwner · (803) 658-5058
Enumeration DateMarch 21, 2022
Last NPPES UpdateJune 17, 20242 updates tracked since enumeration
NPPES CertifiedJune 17, 2024
✔ NPI 1992454532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4027 WOODLAWN ST, Sharon, SC 29742
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Secondary Practice Location 1

Location 1602 S Main StClover, SC 29710-1426 · Phone (803) 658-5058

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.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 42D2256433

Broad River Wellness, LLC · Sharon, SC
Active · expires Mar 23, 2028
CLIA Number42D2256433
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 24, 2026
Certificate Expiration DateMarch 23, 2028
Laboratory DirectorMs. Rebecca R. Baker
Laboratory Phone(803) 627-0220
Laboratory LocationBroad River Wellness, LLC4027 Woodlawn Street, Sharon, SC 29742
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

KENDALL M MORA FNP-C
Nurse Practitioner (Family)
4027 WOODLAWN ST
SHARON, SC 29742
York County (803) 658-5058
REBECCA BAKER FNP-C
Nurse Practitioner (Family)
4027 WOODLAWN ST
SHARON, SC 29742
York County (866) 389-2727
HUYEN DUNG THI BUI NP
Nurse Practitioner (Family)
4027 WOODLAWN ST
SHARON, SC 29742
York County (803) 658-5058

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 Broad River Wellness, LLC's NPI number?

The NPI number for Broad River Wellness, LLC is 1992454532. It was assigned to this organization in the NPPES registry on March 21, 2022.

Where is Broad River Wellness, LLC located?

Broad River Wellness, LLC is located at 4027 Woodlawn St, Sharon, SC 29742. The listed phone number is (803) 627-0220.

What is Broad River Wellness, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Broad River Wellness, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2256433) is associated with this NPI, valid through March 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Broad River Wellness, LLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Broad River Wellness, 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 Broad River Wellness, LLC was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.