# CRESCENT HEALTH PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crescent Medical Clinic, Crescent Mobile Wound Care, Crescent Wound and Medical Clinic, Crescent Occupational Health Clinic, Crescent Wound Care Clinic, Crescent Health Express Care, Crescent Mobile Medical Care, Crescent Health Primary Care, Crescent Health DME, Crescent Health Wellness Clinic, Crescent Medical Foot Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568207702
- **Authorized official:** LISA J RIVERA FNP (COOWNER)
- **Authorized official phone:** (803) 883-4033

## Contact information

- **Practice address:** 212 BROAD STREET, SUMTER, SC 29150-4102
- **Practice address phone:** (803) 580-4747
- **Mailing address:** PO BOX 141, SUMTER, SC 29151-0141
- **Mailing address phone:** (803) 883-4033
- **Mailing address fax:** (803) 883-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WA0400X | Addiction (Substance Use Disorder) Registered Nurse | — | NULL | — |
| 163WA0400X | Addiction (Substance Use Disorder) Registered Nurse | — | — | — |
| 163WW0000X | Wound Care Registered Nurse | — | NULL | — |
| 163WW0000X | Wound Care Registered Nurse | — | — | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |
| 363LX0106X | Occupational Health Nurse Practitioner | — | NULL | — |
| 363LX0106X | Occupational Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/28/2024
- **Last updated:** 10/29/2024