Organization Active NPI

Consultative Gastroenterolgy, PA

  • Specialist
  • Anderson, SC
National Provider Identifier
1104895911
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
PA3736MedicaidSC

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.