Tri-County Pediatrics LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

22018 Issued in SC

Legal business name

TRI-COUNTY PEDIATRICS LLC

Practice address

815 E Liberty St
York, SC 29745-1661

Phone

(803) 329-2700

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Gaurang C Shah, MDNPI 1932169968

Title

Medical Director

Phone

(803) 329-2700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Rural health clinic certification: CCN 428987

Legal name

TRI-COUNTY PEDIATRICS, LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Nov 6, 2007

Last certification

Mar 16, 2023

Ownership / control type

1A

Facility address

815 East Liberty Street
York, SC 29745

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gaurang C Shah, MD

  • Pediatrics Physician
  • Rock Hill, SC
  • NPI 1932169968
  NPD Authorized official
• Colleen Keating Cunningham, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1932748621
  NPD

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1114066883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E LIBERTY ST",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297451661",
            "telephone_number": "803-628-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E LIBERTY ST",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297451661",
            "telephone_number": "803-329-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "GAURANG",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "803-329-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": "22018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thompson Child & Family Focus
• Thompson Child & Family Focus
• Together We Stand
• Ingo Tophoven, LPC-S, LCMHC
• Trellis Pediatric Therapy LLC
• Trinity Medical Transport, LLC
• Karen Turner, PTA
• United Community Care Network, LLC
• Upcountry Primary Care
• Shelaila N Villamor, DO

• Rural Health Clinic/Center in York, SC
• Providers in York, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.