Diabetes Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14684 Issued in SC

Legal business name

DIABETES CENTER LLC

Practice address

11891 Plaza Drive
Murrells Inlet, SC 29576

Phone

(843) 353-0288

Fax

(843) 357-9770

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Brent Russell Nicol

Title

Business Manager

Phone

(843) 353-0288

Specialties & licenses 3

Addresses

Practitioners 2

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

• Susan K Herrington, P.A.-C

  • Medical Physician Assistant
  • Murrells Inlet, SC
  • NPI 1245223353
  NPD (past)
• Kristina Megan Replenski, PA-C

  • Medical Physician Assistant
  • Murrells Inlet, SC
  • NPI 1730583436
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1114117488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15010",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295875010",
            "telephone_number": "843-353-0288",
            "fax_number": "843-257-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11891 PLAZA DRIVE",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-353-0288",
            "fax_number": "843-357-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "843-353-0288",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "30634",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "14684",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "14684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology Associates of Waccamaw LLC
• Sloan Derrick
• Gail Marie Detjen, PT
• Allison Devaux, FNP
• Jared A Devita, PT, DPT
• Michele J Diamond, M.ED.,M.S./CAS, LPES
• Elizabeth Dixon
• Vinh Quang Doan, MD
• Doctors Care, P.a.
• Maureen Dodson, OTR/L,CHT

• Internal Medicine Physician in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.