NPIMap

Organization Active NPI

Oaktree Medical Centre, PC

  • Multi-Specialty Clinic/Center
  • Anderson, SC
National Provider Identifier
1104157718
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
OAKTREE MEDICAL CENTRE, PC
Practice address
108 Montgomery Drive
Anderson, SC 29621-3334
Phone
(864) 225-5597
Fax
(864) 225-5835
NPI assigned
Jan 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Authorized official

Name
Dr. Daniel A McCollum, DC
Title
Ceo
Phone
(864) 343-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

108 Montgomery Drive
Anderson, SC 29621-3334

Mailing address

P.O. Box 484
Easley, SC 29641-4848
Phone (864) 855-1633

Other identifiers 1

IdentifierTypeStateIssuer
GP2763MedicaidSC

Other names 1

  • Pain Management Associates Anderson Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oaktree Medical Centre15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1104157718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 484",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296414848",
            "telephone_number": "864-855-1633",
            "fax_number": "864-855-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MONTGOMERY DRIVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213334",
            "telephone_number": "864-225-5597",
            "fax_number": "864-225-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKTREE MEDICAL CENTRE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-343-2611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2763",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management Associates Anderson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 21, 2010; 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.