Individual provider Active NPI

Joseph Kershaw Newsom Jr., MD

  • Family Medicine Physician
  • Cheraw, SC
National Provider Identifier
1205836970
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
011518 Issued in SC
Practice address
710 Chesterfield Hwy
Cheraw, SC 29520-7001
Phone
(843) 537-2171
Fax
(843) 537-5926
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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 011518 SC Primary

Addresses

Primary practice location

710 Chesterfield Hwy
Cheraw, SC 29520-7001

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 537-2171

Other identifiers 1

IdentifierTypeStateIssuer
115182MedicaidSC

Other names 1

  • Dr. Joseph 'Shaw' Kershaw Newsom Jr. Other name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
011518SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cheraw Family Medicine Family Medicine Current Accepting new patients

Locations

710 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 537-0001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1205836970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-537-2171",
            "fax_number": "843-537-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207001",
            "telephone_number": "843-537-2171",
            "fax_number": "843-537-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOM",
        "first_name": "JOSEPH",
        "middle_name": "KERSHAW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "011518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115182",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPH 'SHAW'",
            "last_name": "NEWSOM",
            "middle_name": "KERSHAW",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cheraw, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.