Sanjin Medical PA

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

17523 Issued in SC

Legal business name

SANJIN MEDICAL PA

Practice address

102 Commons Blvd
Ste C
Piedmont, SC 29673-7766

Phone

(864) 220-9115

Fax

(864) 220-9513

NPI assigned

Feb 27, 2016

Last updated

Feb 27, 2016By 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

Dana Wiley, MDNPI 1427006808

Title

President

Phone

(864) 220-9115

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dana Lee Wiley, MD

  • Psychiatry Physician
  • Piedmont, SC
  • NPI 1427006808
  Authorized official Same address or phone

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456531200000",
    "number": "1144680596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N MAIN ST STE D",
            "address_2": "PMB 171",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214128",
            "telephone_number": "864-220-9115",
            "fax_number": "864-220-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 COMMONS BLVD",
            "address_2": "STE C",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296737766",
            "telephone_number": "864-220-9115",
            "fax_number": "864-220-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJIN MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-27",
        "last_updated": "2016-02-27",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-220-9115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "SC",
            "license": "17523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescribing (Medical) Psychologist in Piedmont, SC
• Providers in Piedmont, SC by specialty
• Prescribing (Medical) Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2016; 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.