Individual provider Active NPI

James R Story, M.D.

  • Cardiovascular Disease Physician
  • Spartanburg, SC
National Provider Identifier
1104863950
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
10272 Issued in SC
Practice address
1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone
(864) 583-8647
Fax
(864) 542-2227
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10272 SC Primary
Interventional Cardiology Physician 207RI0011X 10272 SC

Addresses

Primary practice location

1083 Boiling Springs Rd
Spartanburg, SC 29303-2248

Mailing address

1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone (864) 583-8647

Other identifiers 4

IdentifierTypeStateIssuer
102720MedicaidSC
31368OtherMEDCOST PIN
4276018OtherAETNA PIN
890674CMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000376 SC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 9436244332 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10272SCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jan 20, 1996 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Cardiovascular Disease CurrentSince Jan 20, 1996 Accepting new patients
Mary Black Health System LLC Cardiovascular Disease Past Accepting new patients

Locations

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

1083 Boiling Springs Rd
Spartanburg, SC 29303
Phone (803) 583-8647

2995 Reidville Rd
Ste 210
Spartanburg, SC 29301
Phone (864) 253-8140

1700 Skylyn Dr
Spartanburg, SC 29307
Phone (864) 573-3123

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1104863950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 BOILING SPRINGS RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032248",
            "telephone_number": "864-583-8647",
            "fax_number": "864-542-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 BOILING SPRINGS RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032248",
            "telephone_number": "864-583-8647",
            "fax_number": "864-542-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "10272",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SC",
            "license": "10272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102720",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PIN",
            "identifier": "31368",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4276018",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890674C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.