Active NPI
Spine and Orthopaedic Specialists of South Carolina, PA
- Specialist
- Mount Pleasant, SC
National Provider Identifier
1275754178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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 SC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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
- 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.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Mt Pleasant, SC
- NPI 1669433298
SC
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.