Individual provider Active NPI

Herold Nazon, M.D.

  • Family Medicine Physician
  • Summerville, SC
National Provider Identifier
1184804536
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SC12512 Issued in SC
Practice address
410 N Main St
Summerville, SC 29483-6420
Phone
(843) 871-3277
Fax
(843) 871-3360
NPI assigned
Nov 13, 2007
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SC12512 SC Primary

Addresses

Primary practice location

410 N Main St
Summerville, SC 29483-6420

Mailing address

PO Box 749306
Atlanta, GA 30374-9306
Phone (843) 871-3277

Other practice location 1

1455 Remount Rd
Suite 1A & 1B
North Charleston, SC 29406-3355
Phone (843) 745-9990

Other identifiers 1

IdentifierTypeStateIssuer
GP2608MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150418000026 SC Practitioner - Family PracticePractitioner - General Practice 3173740446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Icahn School of Medicine at Mount Sinai, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

410 N Main St
Summerville, SC 29483-6420
Phone (843) 871-3277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SC12512SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Palmetto Family Care Family Medicine Past Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

1748 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 536-0613

410 N Main St
Summerville, SC 29483
Phone (843) 871-3277

Organizations & group practices 2

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1184804536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306",
            "telephone_number": "843-871-3277",
            "fax_number": "843-871-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836420",
            "telephone_number": "843-871-3277",
            "fax_number": "843-871-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Remount Rd",
            "address_2": "Suite 1A & 1B",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294063355",
            "country_code": "US",
            "telephone_number": "843-745-9990",
            "fax_number": "843-745-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZON",
        "first_name": "HEROLD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "SC12512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2608",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.