NPIMap

Organization Active NPI

Due West Family Medicine PA

  • Rural Health Clinic/Center
  • Due West, SC
National Provider Identifier
1265508550
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DUE WEST FAMILY MEDICINE PA
Practice address
6 College St
Due West, SC 29639
Phone
(864) 379-2345
Fax
(864) 379-3228
NPI assigned
Nov 28, 2006
Last updated
Jan 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Dr. Brian Nelson Henry, MDNPI 1780669564
Title
Owner
Phone
(864) 379-2345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SC Primary

Addresses

Primary practice location

6 College St
Due West, SC 29639

Mailing address

PO Box 638
Due West, SC 29639-0638
Phone (864) 379-2345

Other identifiers 1

IdentifierTypeStateIssuer
RHC074MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1265508550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "DUE WEST",
            "state": "SC",
            "postal_code": "296390638",
            "telephone_number": "864-379-2345",
            "fax_number": "864-379-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COLLEGE ST",
            "city": "DUE WEST",
            "state": "SC",
            "postal_code": "29639",
            "telephone_number": "864-379-2345",
            "fax_number": "864-379-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUE WEST FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-379-2345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC074",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Due West, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.