The Southeastern Spine Institute Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER, LLC

Practice address

1106 Chuck Dawley Blvd
Mt Pleasant, SC 29464-4183

Phone

(843) 669-5162

Fax

(843) 667-4573

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Donald R Johnson II, MD

Title

President

Phone

(843) 669-5162

Specialties & licenses 1

Addresses

Tax ID family

Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Southeastern Spine Institute Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Mount Pleasant, SC
  • NPI 1033373691
  NPD tax ID

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124150297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 DOZIER BLVD",
            "address_2": "SUITE 100",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014090",
            "telephone_number": "843-669-5162",
            "fax_number": "843-667-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 CHUCK DAWLEY BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644183",
            "telephone_number": "843-669-5162",
            "fax_number": "843-667-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "18436695162",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Southeastern Spine Institute Ambulatory Surgery Center, LLC
• The Vision Center at Seaside Farms
• Theobald Family Chiropractic
• David C Theobald, DC
• Therapeutic Counseling South Carolina
• Therapy Group of Charleston LLC (Therapy Group of Charleston)

• Ambulatory Surgical Clinic/Center in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Ambulatory Surgical Clinic/Center in South Carolina

• 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.