Organization Active NPI

Edmund Rhett, Jr., M.D., P.a.

  • Gynecology Physician
  • Mt Pleasant, SC
National Provider Identifier
1104997261
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
8257 Issued in SC
Legal business name
EDMUND RHETT, JR., M.D., P.A.
Practice address
1300 Hospital Dr Ste 150
Mt Pleasant, SC 29464-3243
Phone
(843) 375-2210
Fax
(843) 375-2214
NPI assigned
Nov 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Edmund Rhett Jr., M.D.NPI 1831185990
Title
President
Phone
(843) 375-2210

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 8257 SC Primary

Addresses

Primary practice location

1300 Hospital Dr Ste 150
Mt Pleasant, SC 29464-3243

Mailing address

1300 Hospital Dr Ste 150
Mt Pleasant, SC 29464-3243
Phone (843) 375-2210

Other identifiers 1

IdentifierTypeStateIssuer
GP4566MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070213000385 SC Part B Supplier - Clinic/Group Practice 2961404447 Receives reassigned benefits from 4 practitioners
Practice locations: Mt Pleasant, SC

National Provider Directory

National Provider Directory

Locations

2002 S Fraser St
Georgetown, SC 29440

913 Bowman Rd
Mt Pleasant, SC 29464
Phone (843) 284-6858

Practitioners & affiliated clinicians

Practitioners 4

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": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1104997261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR STE 150",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643243",
            "telephone_number": "843-375-2210",
            "fax_number": "843-375-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR STE 150",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643243",
            "telephone_number": "843-375-2210",
            "fax_number": "843-375-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMUND RHETT, JR., M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "RHETT",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-375-2210",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": "8257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4566",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.