Mdaspect SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MDASPECT SC

Practice address

913 Bowman Rd Ste 104
Mount Pleasant, SC 29464-3235

Phone

(919) 210-6775

Fax

(828) 327-2597

NPI assigned

Oct 22, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roy Dickerson IV

Title

Partner

Phone

(919) 210-6775

Specialties & licenses 1

Addresses

Other names 1

• MDAspect SC, LLC Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Uderitz, M.D.

  • Psychiatry Physician
  • Johns Island, SC
  • NPI 1295963437
  Medicare reassignment NPD
• Tasha Rose Ponce, MA, LMFT

  • Marriage & Family Therapist
  • Johns Island, SC
  • NPI 1124650825
  NPD
• Susan Marie Taylor, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Island, SC
  • NPI 1023797594
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1013550169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20083",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282020027",
            "telephone_number": "919-210-6775",
            "fax_number": "828-327-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 BOWMAN RD STE 104",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643235",
            "telephone_number": "919-210-6775",
            "fax_number": "828-327-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDASPECT SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "919-210-6775",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDAspect SC, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Haley McPherson
• Joanne McTavish, OT
• Ruth M McTighe, MD
• Rebecca A McVey, PSYD, LP, NCSP, BCBA
• Cathleen E McWhirt, MSR, OTR/L
• Me Pivot Holdings LLC
• Me, Simply Kate LLC
• Mollie Meares, MPT
• Medcare Express
• Medical Equipment Solutions of Southeast Florida, LLC

• Psychiatry Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.