Aiken Regional Medical Centers LLC
Organization Active NPI Pediatrics Physician · Aiken, SC
NPI 1295743631 · NPPES record last updated Jan 24, 2022
Key facts
- NPI
- 1295743631
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- HTL-152 (SC)
- Legal business name
- AIKEN REGIONAL MEDICAL CENTERS LLC
- Practice address
- 60 Physician Dr
Aiken, SC 29801-6388 - Phone
- (803) 641-5000
- NPI assigned
- Aug 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Steve Filton
- Title
- Cfo, Senior VP
- Phone
- (610) 768-3300
Other NPIs on the same Medicare enrollment 6
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D1043213 | Palmetto Pediatrics Ctr of Aiken Reg Med Ctr | Certificate of waiver | Jul 18, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031125000288 | SC | Part B Supplier - Clinic/Group Practice | 9739083312 |
Receives reassigned benefits from 59 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Aiken, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | HTL-152 | SC | Yes |
Addresses
Primary practice location
60 Physician Dr
Aiken, SC 29801-6388
Mailing address
60 Physician Dr
Aiken, SC 29801-6388
Phone (803) 641-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400827 | Medicaid | SC | |
| GP4224 | Medicaid | SC |
Other names
- Palmetto Pediatrics
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Aiken, SC
- Aiken Psychotherapy and Counseling Inc
- Aiken Pulmonary Associates, LLC
- Aiken Radiation Oncology, P.a.
- Aiken Regional Medical Centers
- Aiken Regional Medical Centers LLC
- Aiken Regional Medical Centers LLC
- Aiken Regional Medical Centers LLC
- Aiken Regional Medical Centers LLC
- Aiken Regional Medical Centers LLC
- Aiken Regional Medical Centers LLC
All providers in Aiken, SC · Pediatrics Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.