South North Medical Center LLC
NPI 1750210704ActiveOrganization· Internal Medicine· Irmo, SC
Internal Medicine in Irmo, South Carolina, registered in NPPES in May 2026. The authorized official on file is Lense Tessema Duresso, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1750210704 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 15, 2026 |
| Last updated in NPPES | May 15, 2026 |
| Certified by provider | May 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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