John William Pence Sr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9698 Issued in SC

Practice address

1815 Old Trolley Rd
Summerville, SC 29485

Phone

(843) 875-0440

Fax

(843) 875-0442

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245260876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29485",
            "telephone_number": "843-875-0440",
            "fax_number": "843-875-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29485",
            "telephone_number": "843-875-0440",
            "fax_number": "843-875-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCE",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "9698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL9452",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Orthopedics of Charleston
• Amanda W Peebles, FNP-C
• Conner Elizabeth Peek, LPC
• Ashliegh Marriah Pelton, NP
• Pelvic Flores, LLC
• Kisha Beach Penn
• Taylor Findley Penny, DO
• Pentz Family Chiropractic Life Center
• T. Craig Pentz, D.C
• Brad Duncan Peper, DMD

• Pediatrics Physician in Summerville, SC
• Providers in Summerville, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.