Organization Active NPI

Spine and Orthopaedic Specialists of South Carolina, PA

  • Specialist
  • Mount Pleasant, SC
National Provider Identifier
1275754178
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SPINE AND ORTHOPAEDIC SPECIALISTS OF SOUTH CAROLINA, PA
Practice address
526 Johnnie Dodds Blvd Ste 301
Mount Pleasant, SC 29464-3029
Phone
(843) 856-9669
Fax
(843) 856-9161
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Tracie Ann Alexander
Title
Office Manager
Phone
(843) 856-9669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

526 Johnnie Dodds Blvd Ste 301
Mount Pleasant, SC 29464-3029

Mailing address

526 Johnnie Dodds Blvd Ste 301
Mount Pleasant, SC 29464-3029
Phone (843) 856-9669

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041227000407 SC Part B Supplier - Clinic/Group Practice 6709844566 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, SC; Mt Pleasant, SC
O20180205001425 SC DME Supplier - Physician - General Practice 6709844566 Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Locations

526 Johnnie Dodds Blvd
Ste 301
Mt Pleasant, SC 29464
Phone (843) 856-9669

1311 Chuck Dawley Blvd
Ste 102
Mt Pleasant, SC 29464
Phone (843) 856-9669

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBDCA

Practitioners & affiliated clinicians

Practitioners 1

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": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1275754178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 JOHNNIE DODDS BLVD STE 301",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643029",
            "telephone_number": "843-856-9669",
            "fax_number": "843-856-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 JOHNNIE DODDS BLVD STE 301",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643029",
            "telephone_number": "843-856-9669",
            "fax_number": "843-856-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND ORTHOPAEDIC SPECIALISTS OF SOUTH CAROLINA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-856-9669"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.