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

Organization subpart

No

Name

Dana Wiley, MD

Title

President

Phone

(864) 220-9115

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 27, 2016.

{
    "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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• All providers in Piedmont, SC
• 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.