NPIMap

Organization Active NPI

South Carolina Podiatric Physicians and Surgeons Group, LLC

  • Primary Podiatric Medicine Podiatrist
  • Lancaster, SC
National Provider Identifier
1063834646
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Practice address
1190 Highway 9 Byp W
Lancaster, SC 29720-1709
Phone
(803) 285-1411
Fax
(803) 283-9920
NPI assigned
Jan 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Brandon S Percival, DPM
Title
President
Phone
(803) 285-1411

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

1190 Highway 9 Byp W
Lancaster, SC 29720-1709

Mailing address

8141 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 492-2293

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1063834646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-492-2293",
            "fax_number": "888-383-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 HIGHWAY 9 BYP W",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297201709",
            "telephone_number": "803-285-1411",
            "fax_number": "803-283-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "PERCIVAL",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-285-1411",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.