NPIMap

Organization Active NPI

Genesis Healthcare, Inc.

Doing business as Walterboro Family Care and Pediatrics

  • General Practice Dentistry
  • Walterboro, SC
National Provider Identifier
1073499356
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GENESIS HEALTHCARE, INC.
Doing business as
Walterboro Family Care and Pediatrics
Practice address
830 Robertson Blvd
Walterboro, SC 29488-3081
Phone
(843) 781-7428
Fax
(843) 781-7429
NPI assigned
Aug 13, 2025
Last updated
Aug 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Mr. Tony Megna
Title
Ceo
Phone
(803) 254-3676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

830 Robertson Blvd
Walterboro, SC 29488-3081

Mailing address

8906 Two Notch Rd
Columbia, SC 29223-6366
Phone (803) 254-3676

Other names 1

  • Walterboro Family Care and Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genesis Healthcare Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1073499356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236366",
            "telephone_number": "803-254-3676",
            "fax_number": "803-254-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294883081",
            "telephone_number": "843-781-7428",
            "fax_number": "843-781-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "MEGNA",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-254-3676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walterboro Family Care and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.