Individual provider Active NPI

Stephen E Parks, MD

  • Family Medicine Physician
  • Simpsonville, SC
National Provider Identifier
1154387140
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10976 Issued in SC
Practice address
35 Ray E Talley CT
Simpsonville, SC 29680-6772
Phone
(864) 967-7028
Fax
(864) 228-0915
NPI assigned
Apr 26, 2006
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10976 SC Primary
Emergency Medicine Physician 207P00000X 10976 SC

Addresses

Primary practice location

35 Ray E Talley CT
Simpsonville, SC 29680-6772

Mailing address

1818 Henderson St
Columbia, SC 29201-2647
Phone (803) 782-4278

Other identifiers 1

IdentifierTypeStateIssuer
109769MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041013000763 SC Practitioner - Family PracticePractitioner - Emergency Medicine 1557321650 Reassigns benefits to 1 organization
I20180808002555 NC Practitioner - Emergency Medicine 1557321650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Medical University of South Carolina College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Infusion Services LLCGroup PAC ID 4688578826, 60 clinicians

Practice addresses (Care Compare)

1027 Physicians Dr
Suite 220
Charleston, SC 29414-5352
Phone (803) 771-7740

110 Mutual Dr
Anderson, SC 29621-1767
Phone (800) 809-1265

141 Halton Village Cir
Greenville, SC 29607-6825
Phone (864) 370-3900

1551 Westbrook Plaza Dr
Suite 100
Winston Salem, NC 27103-1355
Phone (743) 999-7220

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10976SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Infusion Services LLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

3315 Springbank Ln
Ste 100
Charlotte, NC 28226
Phone (704) 200-9482

1551 Westbrook Plaza Dr
Ste 100
Winston Salem, NC 27103
Phone (743) 999-7220

110 Mutual Dr
Anderson, SC 29621

1027 Physicians Dr
Ste 220
Charleston, SC 29414
Phone (843) 553-7588

141 Halton Village Cir
Greenville, SC 29607
Phone (864) 370-3900

1650 Skylyn Dr
Ste 350
Spartanburg, SC 29307
Phone (864) 699-9771

3105 Sunset Blvd
West Columbia, SC 29169
Phone (843) 314-2060

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1154387140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012647",
            "telephone_number": "803-782-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RAY E TALLEY CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806772",
            "telephone_number": "864-967-7028",
            "fax_number": "864-228-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "10976",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "10976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109769",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.