S.C. State University

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

S.C. STATE UNIVERSITY

Practice address

300 College Street, NE
300 Colleg Street, NE
Orangeburg, SC 29117-0001

Phone

(803) 536-8073

Fax

(803) 533-3627

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gwendolyn D. Wilson

Title

Department Chair

Phone

(803) 536-7063

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Demarcus Fitzgerald Bush, AU.D.

  • Audiologist
  • Orangeburg, SC
  • NPI 1821226333
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1033288402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COLLEGE STREET, NE",
            "address_2": "P O BOX 7427",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291170001",
            "telephone_number": "803-536-8073",
            "fax_number": "803-533-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLLEGE STREET, NE",
            "address_2": "300 COLLEG STREET, NE",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291170001",
            "telephone_number": "803-536-8073",
            "fax_number": "803-533-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.C. STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "803-536-7063",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349987",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Victoria Rucker
• Jordana Ruffner, D.O.
• Eunice M Rush-Howell
• Kelly L Russo, PH.D.
• S.C. Department of Health and Environmental Control
• Safiyah J Salih, DDS
• Jodi Salley, SLP
• Lawton Haris Salley, MD
• Michael Everette Salley, D.M.D.
• Pamela Salters, MA COUNSELING

• Speech-Language Pathologist in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.