Organization Active NPI

Carolina Diabetes and Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Anderson, SC
National Provider Identifier
1104006154
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
19586 Issued in SC
Legal business name
CAROLINA DIABETES AND ENDOCRINOLOGY
Practice address
1221 N Fant St
Anderson, SC 29621-4821
Phone
(864) 261-6440
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Samuel A Yeboah, M .D.NPI 1568547479
Title
President
Phone
(864) 261-6440

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)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 19586 SC Primary

Addresses

Primary practice location

1221 N Fant St
Anderson, SC 29621-4821

Mailing address

1221 N Fant St
Anderson, SC 29621-4821
Phone (864) 261-6440

National Provider Directory

National Provider Directory

Locations

603 N Main St
Anderson, SC 29621
Phone (864) 226-8889

603 N Main St
Anderson, SC 29621
Phone (864) 226-8889

Practitioners & affiliated clinicians

Practitioners 2

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": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1104006154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214821",
            "telephone_number": "864-261-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214821",
            "telephone_number": "864-261-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA DIABETES AND ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "YEBOAH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-261-6440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M .D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "19586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.