Organization Active NPI

Piedmont Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Greenwood, SC
National Provider Identifier
1255464376
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
12007 Issued in SC
Legal business name
PIEDMONT PLASTIC SURGERY
Practice address
305A W Alexander Ave
Greenwood, SC 29646-4009
Phone
(864) 223-0505
Fax
(864) 223-7075
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Ted R Vaughn, M.D.
Title
Surgeon
Phone
(864) 223-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 12007 SC Primary

Addresses

Primary practice location

305A W Alexander Ave
Greenwood, SC 29646-4009

Mailing address

305A W Alexander Ave
Greenwood, SC 29646-4009
Phone (864) 223-0505

Other identifiers 1

IdentifierTypeStateIssuer
GP0728MedicaidSC

National Provider Directory

National Provider Directory

Locations

305A W Alexander Ave
Greenwood, SC 29646
Phone (864) 223-0505

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1255464376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305A W ALEXANDER AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464009",
            "telephone_number": "864-223-0505",
            "fax_number": "864-223-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305A W ALEXANDER AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464009",
            "telephone_number": "864-223-0505",
            "fax_number": "864-223-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "864-223-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "SC",
            "license": "12007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0728",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.