Dhec

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

235692 Issued in SC

Legal business name

DHEC

Practice address

319 Stephen CT
Mullins, SC 29574-4223

Phone

(843) 992-9132

NPI assigned

Feb 27, 2017

Last updated

Feb 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Jackson

Title

RN

Phone

(843) 992-9132

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1023558905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 STEPHEN CT",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295744223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 STEPHEN CT",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295744223",
            "telephone_number": "843-992-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHEC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "843-992-9132"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "SC",
            "license": "235692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corrie Maria Davis, RD, LD, CNSC
• Parmanand Dawani, M.D.
• Robert Louis De Grood, MD
• Jeromy Deakins, MAATERS
• James Louis Dedonis, MD
• Bryan Dickison
• Okechukwu Dimkpa, MD
• Eagle Nursing LLC
• Mitchell E Falk, D.C.
• Luna Renea Fleming

• Nursing Facility/Intermediate Care Facility in Mullins, SC
• Providers in Mullins, SC by specialty
• Nursing Facility/Intermediate Care Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.