Active NPI
Rebecca J Borders, DO
- Family Medicine Physician
- Edisto Island, SC
National Provider Identifier
1023039823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- SC0181
- Practice address
- 805 Oyster Park Dr
Edisto Island, SC 29438-6837 - Phone
- (843) 869-3111
- Fax
- (843) 869-3344
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | SC0181 | SC | Primary |
Addresses
Primary practice location
805 Oyster Park Dr
Edisto Island, SC 29438-6837
Mailing address
805 Oyster Park Dr
Edisto Island, SC 29438-6837
Phone (843) 869-3111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001811 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110105000444 | SC | Practitioner - General Practice | 6002920758 | Practice locations: Edisto Island, SC |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC0181 | SC | MD | Family Medicine Physician |
| 181 | SC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1023039823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 OYSTER PARK DR",
"city": "EDISTO ISLAND",
"state": "SC",
"postal_code": "294386837",
"telephone_number": "843-869-3111",
"fax_number": "843-869-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 OYSTER PARK DR",
"city": "EDISTO ISLAND",
"state": "SC",
"postal_code": "294386837",
"telephone_number": "843-869-3111",
"fax_number": "843-869-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDERS",
"first_name": "REBECCA",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "SC0181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001811",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edisto Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.