NPIMap

Organization Active NPI

Genpsych of South Carolina, LLC

  • Psychiatry Physician
  • Sumter, SC
National Provider Identifier
1114214665
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21075 Issued in SC
Legal business name
GENPSYCH OF SOUTH CAROLINA, LLC
Practice address
2 Medical CT
Sumter, SC 29150-4760
Phone
(803) 774-4020
Fax
(803) 774-4025
NPI assigned
Jul 6, 2011
Organization subpart
Yes
Parent organization
GENPSYCH, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Dr. Henry Odunlami, M.D.
Title
Ceo
Phone
(908) 231-0511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 21075 SC Primary

Addresses

Primary practice location

2 Medical CT
Sumter, SC 29150-4760

Mailing address

2 Medical CT
Sumter, SC 29150-4760
Phone (803) 774-4020

National Provider Directory

National Provider Directory
Tax ID family
Genpsych Inc2 organizations share this tax ID, including this one
Part of
Genpsych PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1114214665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504760",
            "telephone_number": "803-774-4020",
            "fax_number": "803-774-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504760",
            "telephone_number": "803-774-4020",
            "fax_number": "803-774-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENPSYCH OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENPSYCH, PC",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "ODUNLAMI",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-231-0511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "21075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.