Organization Active NPI

Robert Wozniak MD PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Rock Hill, SC
National Provider Identifier
1255499950
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
21019 Issued in SC
Legal business name
ROBERT WOZNIAK MD PA
Practice address
410 S Herlong Ave
Suite 106
Rock Hill, SC 29732-8349
Phone
(803) 329-3899
Fax
(803) 329-4377
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Dr. Robert Wozniak, MDNPI 1942282470
Title
President
Phone
(803) 329-3899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 21019 SC Primary

Addresses

Primary practice location

410 S Herlong Ave
Suite 106
Rock Hill, SC 29732-8349

Mailing address

410 S Herlong Ave
Suite 106
Rock Hill, SC 29732-8349
Phone (803) 329-3899

Other identifiers 2

IdentifierTypeStateIssuer
1942282470OtherSCNPI INDIVIDUAL
210195MedicaidSC

Other names 1

  • Lancaster Endocrinology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000136 NC Part B Supplier - Clinic/Group Practice 5193638898 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC
O20040427000141 SC Part B Supplier - Clinic/Group Practice 5193638898 Receives reassigned benefits from 4 practitioners
Practice locations: Rock Hill, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0965962Lancaster Endocrinology410 South Herlong Avenue Ste 106, Rock Hill, SC 29732Certificate of waiverOct 4, 2027

National Provider Directory

National Provider Directory

Locations

16147 Lancaster Hwy
Ste 140
Charlotte, NC 28277
Phone (704) 208-4134

410 Herlong Ave S
Ste 106
Rock Hill, SC 29732
Phone (803) 329-3899

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1255499950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S HERLONG AVE",
            "address_2": "SUITE 106",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328349",
            "telephone_number": "803-329-3899",
            "fax_number": "803-329-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S HERLONG AVE",
            "address_2": "SUITE 106",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328349",
            "telephone_number": "803-329-3899",
            "fax_number": "803-329-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT WOZNIAK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "WOZNIAK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-329-3899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "21019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1942282470",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210195",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lancaster Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.