Charleston Facial Plastic Surgery LLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

TL36529 Issued in SC

Legal business name

CHARLESTON FACIAL PLASTIC SURGERY LLC

Practice address

67 Broad St
Suite 200
Charleston, SC 29401-2936

Phone

(843) 882-7181

NPI assigned

Apr 15, 2014

Last updated

Apr 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Wastson Rodwell III, M.D.NPI 1063687325

Title

Owner

Phone

(843) 882-7181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Watson Rodwell III, M.D.

  • Facial Plastic Surgery Physician
  • Charleston, SC
  • NPI 1063687325
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1194144493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 E SHORE LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BROAD ST",
            "address_2": "SUITE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012936",
            "telephone_number": "843-882-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON FACIAL PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "RODWELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WASTSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-882-7181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "SC",
            "license": "TL36529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Charleston Eye Care PA Inc
• Charleston Family Center, LLC
• Charleston Family Dentistry of West Ashley
• Charleston Gastroenterology Specialists
• Charleston Gastroenterology Specialists
• Charleston Hand Therapy Center

• Facial Plastic Surgery Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Facial Plastic Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.