NPIMap

Organization Active NPI

Medically Fragile Childrens Program

  • Developmental Disabilities Clinic/Center
  • N Charleston, SC
National Provider Identifier
1023153996
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MEDICALLY FRAGILE CHILDRENS PROGRAM
Practice address
2750 Speissegger Drive
Suite 108
N Charleston, SC 29405-8701
Phone
(843) 876-7007
Fax
(843) 554-9230
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. William Stuart Smith
Title
Executive Director
Phone
(843) 792-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU Primary

Addresses

Primary practice location

2750 Speissegger Drive
Suite 108
N Charleston, SC 29405-8701

Mailing address

2750 Speissegger Drive
Suite 108
N Charleston, SC 29405-8701
Phone (843) 876-7007

Other identifiers 1

IdentifierTypeStateIssuer
DRC009MedicaidSC

Other names 1

  • Medical University Hospital Authority Other name

National Provider Directory

National Provider Directory
Tax ID family
Musc Hospital71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

2750 Speissegger Dr
Ste 108
North Charleston, SC 29405
Phone (843) 876-7007

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023153996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 SPEISSEGGER DRIVE",
            "address_2": "SUITE 108",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294058701",
            "telephone_number": "843-876-7007",
            "fax_number": "843-554-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SPEISSEGGER DRIVE",
            "address_2": "SUITE 108",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294058701",
            "telephone_number": "843-876-7007",
            "fax_number": "843-554-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALLY FRAGILE CHILDRENS PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-792-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DRC009",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical University Hospital Authority",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in N Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.