NPIMap

Organization Active NPI

Seneca Family Practice, P.a.

  • Family Medicine Physician
  • Seneca, SC
National Provider Identifier
1093781643
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18829 Issued in SC
Legal business name
SENECA FAMILY PRACTICE, P.A.
Practice address
867 Whitworth Cir
Seneca, SC 29672-9435
Phone
(864) 882-7400
Fax
(864) 882-7401
NPI assigned
Feb 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Mrs. Michele M. Kidd
Title
Office Manager
Phone
(864) 882-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 18829 SC Primary

Addresses

Primary practice location

867 Whitworth Cir
Seneca, SC 29672-9435

Mailing address

867 Whitworth Cir
Seneca, SC 29672-9435
Phone (864) 882-7400

Other identifiers 1

IdentifierTypeStateIssuer
GP2970MedicaidSC

National Provider Directory

National Provider Directory

Locations

867 Whitworth Cir
Seneca, SC 29672
Phone (864) 882-7400

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1093781643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 WHITWORTH CIR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729435",
            "telephone_number": "864-882-7400",
            "fax_number": "864-882-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 WHITWORTH CIR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729435",
            "telephone_number": "864-882-7400",
            "fax_number": "864-882-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENECA FAMILY PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-882-7400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2970",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.