Organization Active NPI

Willie B Louis MD PA

  • Family Medicine Physician
  • Orangeburg, SC
National Provider Identifier
1154534972
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7519 Issued in SC
Legal business name
WILLIE B LOUIS MD PA
Practice address
1102 Summers Ave
Orangeburg, SC 29115-4922
Phone
(803) 534-2270
Fax
(803) 534-2271
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Dr. Willie B. LouisNPI 1912914284
Title
M.D.
Phone
(803) 534-2270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7519 SC Primary

Addresses

Primary practice location

1102 Summers Ave
Orangeburg, SC 29115-4922

Mailing address

1102 Summers Ave
Orangeburg, SC 29115-4922
Phone (803) 534-2270

Other identifiers 1

IdentifierTypeStateIssuer
GP4128MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050412001353 SC Part B Supplier - Clinic/Group Practice 5890732705 Receives reassigned benefits from 1 practitioner
Practice locations: Orangeburg, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1040638Willie B Louis MD PA1102 Summers Avenue, Orangeburg, SC 29115Certificate of waiverOct 31, 2026

National Provider Directory

National Provider Directory

Locations

1102 Summers Ave
Orangeburg, SC 29115
Phone (803) 534-2270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1154534972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SUMMERS AVE",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154922",
            "telephone_number": "803-534-2270",
            "fax_number": "803-534-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SUMMERS AVE",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154922",
            "telephone_number": "803-534-2270",
            "fax_number": "803-534-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIE B LOUIS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "LOUIS",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "803-534-2270",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "7519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4128",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.