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Carmen Ridgeway Butler

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

115 N Sumter St Ste 305, Sumter, SC 29150-4967

PECOS Enrollment

This provider is enrolled in PECOS as CARMEN BUTLER.

Based on the most recent information from CMS, provider Carmen Ridgeway Butler is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:14 PM.

Profile Details

Provider ID
1659845782
Provider Type
Individual
Full Name
Butler, Carmen Ridgeway
Title
Mrs.
Credential
FNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
1/11/2019
Last Updated
1/11/2019

Contact Information

Practice Location

115 N Sumter St Ste 305, Sumter, SC 29150-4967

(803) 305-1117

Unlisted Fax

Mailing Location

1088 Pond View Rd, Manning, SC 29102-7816

(803) 460-4640

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 22202 South Carolina

Carmen Ridgeway Butler

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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