Organization Active NPI

Compass Family Medicine,PA

  • Family Medicine Physician
  • Newberry, SC
National Provider Identifier
1093812224
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14534 Issued in SC
Legal business name
COMPASS FAMILY MEDICINE,PA
Practice address
2605 Kinard Street
Suite 208
Newberry, SC 29108-2909
Phone
(803) 276-4860
Fax
(803) 276-2812
NPI assigned
Sep 20, 2006
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Margaret Nickerson
Title
Office Manager
Phone
(803) 276-4860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14534 SC Primary

Addresses

Primary practice location

2605 Kinard Street
Suite 208
Newberry, SC 29108-2909

Mailing address

2605 Kinard St Ste 208
Newberry, SC 29108-2966
Phone (803) 276-4860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121101000386 SC Part B Supplier - Clinic/Group Practice 7315197167 Receives reassigned benefits from 1 practitioner
Practice locations: Newberry, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1093812224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KINARD ST STE 208",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082966",
            "telephone_number": "803-276-4860",
            "fax_number": "803-276-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KINARD STREET",
            "address_2": "SUITE 208",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082909",
            "telephone_number": "803-276-4860",
            "fax_number": "803-276-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS FAMILY MEDICINE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "NICKERSON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-276-4860"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "14534",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 28, 2012; 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.

Verify at the official NPI Registry.