Otis Boyd Gardo Jr

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

OTIS BOYD GARDO JR

Doing business as

Highlands Anaplastology Associates

Practice address

1007 Grove Rd
Suite E
Greenville, SC 29605-4630

Phone

(864) 232-3008

Fax

(864) 845-8556

NPI assigned

Feb 11, 2008

Last updated

Feb 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Rebecca J. Gardo

Title

Office Manager

Phone

(864) 232-3008

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• HIGHLANDS ANAPLASTOLOGY ASSOCIATES Doing business as

Locations

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.

• O Boyd Gardo Jr., ANAPLASTOLOGIST

  • Orthotic Fitter
  • Anderson, SC
  • NPI 1164489191
  NPD (past)

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1093983215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 COOL MEADOWS DR",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296738941",
            "telephone_number": "864-232-3008",
            "fax_number": "864-845-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 GROVE RD",
            "address_2": "SUITE E",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-232-3008",
            "fax_number": "864-845-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTIS BOYD GARDO JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "GARDO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-232-3008",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530923946B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704873",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2711",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIGHLANDS ANAPLASTOLOGY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ossp Imaging of Greenville
• Sarah Michelle Osteen
• Emily Ostroski
• Lindsay Cordell Oswald, M.ED, LPC
• William Michael Oswald, RPH
• Anna Pepin Ott, MSN, FNP
• Andrew T Otto, PA-C
• Deborah Ruth Ousley, LPN
• Donna Shilane Outlaw-Thomas, APRN-PMHNP
• Mitchell Graham Outlaw

• Customized Equipment (DME) in Greenville, SC
• Providers in Greenville, SC by specialty
• Customized Equipment (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.