Moncks Corner Pediatrics LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MONCKS CORNER PEDIATRICS LLC

Practice address

5000 Epson Plantation Dr Ste B
Moncks Corner, SC 29461-3979

Phone

(843) 761-2000

Fax

(843) 761-2267

NPI assigned

Jun 7, 2010

Last updated

Jun 7, 2010By 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. Joseph R West Jr., MDNPI 1861503146

Title

Owner

Phone

(843) 761-2000

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Joseph West, MD

  • Pediatrics Physician
  • Powdersville, SC
  • NPI 1861503146

  Rural Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1245550821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 EPSON PLANTATION DR STE B",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613979",
            "telephone_number": "843-761-2000",
            "fax_number": "843-761-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 EPSON PLANTATION DR STE B",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613979",
            "telephone_number": "843-761-2000",
            "fax_number": "843-761-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONCKS CORNER PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-761-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC188",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wyatt Mitchell, LMSW
• Janice Mitchum
• Lauren Mitchum
• Moncks Corner Dental Group, PC (Moncks Corner Dental Group)
• Moncks Corner Pediatrics LLC
• Moncks Corner Physical Therapy, LLC
• Laquawn J Montgomery
• Joseph Carlisle Moore Jr., M.D.
• Kathleen Bailey Moore, RN, BSN
• Sandy Moore, RN

• Rural Health Clinic/Center in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.