St. Andrews Surgical Assoc. PC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

MD5755 Issued in SC

Legal business name

ST. ANDREWS SURGICAL ASSOC. PC

Practice address

1006 Old Chapin Rd
Lexington, SC 29072-9549

Phone

(803) 359-7434

NPI assigned

Jul 16, 2008

Last updated

Jul 16, 2008By 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. Frederick Wayne Clemenz, M.D.

Title

Owner

Phone

(803) 359-7434

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1265696439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 OLD CHAPIN RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729549",
            "telephone_number": "803-359-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 OLD CHAPIN RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729549",
            "telephone_number": "803-359-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANDREWS SURGICAL ASSOC. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "CLEMENZ",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-359-7434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "MD5755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057556",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan K Springer, DMD
• Celeste Hiott Springer, DMD
• Savanah Springer, NP
• Amanda Myers Sprouse, MSW, LISW-CP
• Shannon Spry, OT
• Kaytlin Stackpole, MRC
• Clifford D Staggs, MD
• Kaylie Marie Stamco
• Kerri Stanford, MSP CCC-SLP
• Elisa Randi Stanley, LMT

• Geriatric Medicine (Family Medicine) Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• Geriatric Medicine (Family Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.