NPIMap

Organization Active NPI

Edisto Regional Health Services

  • Family Medicine Physician
  • Orangeburg, SC
National Provider Identifier
1285641332
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APN652 Issued in SC
Legal business name
EDISTO REGIONAL HEALTH SERVICES
Practice address
2850 Pelham CT
Orangeburg, SC 29118-1400
Phone
(803) 655-6132
Fax
(803) 655-6173
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Thomas Dandridge I
Title
President
Phone
(803) 395-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X APN652 SC Primary

Addresses

Primary practice location

2850 Pelham CT
Orangeburg, SC 29118-1400

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4499

Other identifiers 1

IdentifierTypeStateIssuer
GP3748MedicaidSC

Other names 1

  • COPELAND MEDICAL CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Low Country Pain Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1285641332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4499",
            "fax_number": "803-395-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 PELHAM CT",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181400",
            "telephone_number": "803-655-6132",
            "fax_number": "803-655-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO REGIONAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "DANDRIDGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-395-2200",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "APN652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3748",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPELAND MEDICAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.