Active NPI
Antonio Lamar Rivers, HAIR LOSS SPECIALIS
- Prosthetics Case Management
- North Charleston, SC
National Provider Identifier
1164033742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 2677
- Practice address
- 2702 W Surrey Dr
North Charleston, SC 29405-5513 - Phone
- (843) 224-3574
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 2677 | SC | Primary |
Addresses
Primary practice location
2702 W Surrey Dr
North Charleston, SC 29405-5513
Mailing address
2702 W Surrey Dr
North Charleston, SC 29405-5513
Phone (843) 224-3574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2677 | SC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597536000000",
"number": "1164033742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2702 W SURREY DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294055513",
"telephone_number": "843-224-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2702 W SURREY DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294055513",
"telephone_number": "843-224-3574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERS",
"first_name": "ANTONIO",
"middle_name": "LAMAR",
"name_prefix": "Mr.",
"credential": "HAIR LOSS SPECIALIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-16",
"last_updated": "2020-08-16",
"certification_date": "2020-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "SC",
"license": "2677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.