Active NPI
Newberry Surgical LLC
- Surgery Physician
- Newberry, SC
National Provider Identifier
1073072468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- NEWBERRY SURGICAL LLC
- Practice address
- 2660 Kinard St
Newberry, SC 29108-2912 - Phone
- (912) 278-4819
- NPI assigned
- Mar 15, 2019
- Last updated
- Jun 28, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William H Cantey, MD
- Title
- Owner/Employee
- Phone
- (912) 278-4819
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
2660 Kinard St
Newberry, SC 29108-2912
Mailing address
2660 Kinard St
Newberry, SC 29108-2912
Phone (803) 597-5225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188175 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2660 Kinard St
Newberry, SC 29108
Phone (803) 405-9911
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.
-
- Surgery Physician
- Newberry, SC
- NPI 1164427811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719532800000",
"number": "1073072468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 KINARD ST",
"city": "NEWBERRY",
"state": "SC",
"postal_code": "291082912",
"telephone_number": "803-597-5225",
"fax_number": "803-597-5228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2660 KINARD ST",
"city": "NEWBERRY",
"state": "SC",
"postal_code": "291082912",
"telephone_number": "912-278-4819"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEWBERRY SURGICAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-15",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A",
"authorized_official_last_name": "CANTEY",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "OWNER/EMPLOYEE",
"authorized_official_telephone_number": "912-278-4819",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188175",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newberry, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.