Clio Medical Center,Inc

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

113139 Issued in SC

Legal business name

CLIO MEDICAL CENTER,INC

Practice address

200 Main St
Clio, SC 29525

Phone

(843) 586-2292

NPI assigned

Feb 8, 2007

Last updated

Aug 17, 2007By 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

Mr. Pravin R Patel, MDNPI 1215973532

Title

Physician

Phone

(843) 586-2292

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Pravin R Patel, MD

  • Family Medicine Physician
  • Clio, SC
  • NPI 1215973532
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1285774125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "CLIO",
            "state": "SC",
            "postal_code": "29525",
            "telephone_number": "843-586-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "CLIO",
            "state": "SC",
            "postal_code": "29525",
            "telephone_number": "843-586-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO MEDICAL CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRAVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-586-2292",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "113139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC120",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adolescent Medicine (Family Medicine) Physician in Clio, SC
• Providers in Clio, SC by specialty
• Adolescent Medicine (Family Medicine) Physician in South Carolina

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