Edisto Multispecialty Associates Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EDISTO MULTISPECIALTY ASSOCIATES INC

Doing business as

dba Edisto Pediatrics

Practice address

302 Medical Park Dr
Suite 211
Walterboro, SC 29488-5747

Phone

(843) 549-0787

Fax

(843) 549-6867

NPI assigned

Oct 17, 2005

Last updated

Aug 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert England

Title

Coordinator

Phone

(800) 661-3365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba Edisto Pediatrics Doing business as

Locations

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1144219726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MEDICAL PARK DR",
            "address_2": "SUITE 211",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885747",
            "telephone_number": "843-549-0787",
            "fax_number": "843-549-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MEDICAL PARK DR",
            "address_2": "SUITE 211",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885747",
            "telephone_number": "843-549-0787",
            "fax_number": "843-549-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO MULTISPECIALTY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "ENGLAND",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "800-661-3365",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC508/GP3156",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Edisto Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.