Active NPI
Consultative Gastroenterolgy, PA
- Specialist
- Anderson, SC
National Provider Identifier
1104895911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- CONSULTATIVE GASTROENTEROLGY, PA
- Practice address
- 118 Montgomery Dr
Anderson, SC 29621-3334 - Phone
- (864) 224-1692
- Fax
- (864) 224-0103
- NPI assigned
- Mar 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carl M Lund, M.D.
- Title
- President
- Phone
- (864) 224-1692
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
118 Montgomery Dr
Anderson, SC 29621-3334
Mailing address
118 Montgomery Dr
Anderson, SC 29621-3334
Phone (864) 224-1692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA3736 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
1922 McConnell Springs Rd
Ste B
Anderson, SC 29621
Phone (864) 716-6555
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Anderson, SC
- NPI 1023009644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1104895911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 MONTGOMERY DR",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296213334",
"telephone_number": "864-224-1692",
"fax_number": "864-224-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 MONTGOMERY DR",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296213334",
"telephone_number": "864-224-1692",
"fax_number": "864-224-0103"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONSULTATIVE GASTROENTEROLGY, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LUND",
"authorized_official_first_name": "CARL",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "864-224-1692",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA3736",
"state": "SC"
}
],
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.