NPIMap

Organization Active NPI

I Med Carolinas LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Mill, SC
National Provider Identifier
1053800821
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
I MED CAROLINAS LLC
Practice address
105 Stone Village Dr
Fort Mill, SC 29708-6489
Phone
(803) 543-2610
NPI assigned
May 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Authorized official

Name
Farshad HosseiniNPI 1770040073
Title
Managing Director
Phone
(877) 862-0061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

105 Stone Village Dr
Fort Mill, SC 29708-6489

Mailing address

2764 Pleasant Rd # 11605
Fort Mill, SC 29708-7213

National Provider Directory

National Provider Directory

Locations

2764 Pleasant Rd
#11605
Fort Mill, SC 29708

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1053800821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2764 PLEASANT RD # 11605",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 STONE VILLAGE DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086489",
            "telephone_number": "803-543-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I MED CAROLINAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "HOSSEINI",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "877-862-0061"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.