Organization Active NPI

Physicians Health & Injury Clinic

  • General Practice Physician
  • Sumter, SC
National Provider Identifier
1306037676
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7414 Issued in SC
Legal business name
PHYSICIANS HEALTH & INJURY CLINIC
Practice address
711 Bultman Drive
Sumter, SC 29150
Phone
(803) 773-3421
Fax
(803) 773-8458
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
Duangmani Friday, DCNPI 1538239694
Title
Owner DC
Phone
(803) 773-3421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1857 SC
Chiropractor 111N00000X 1773 SC
General Practice Physician 208D00000X 7414 SC Primary

Addresses

Primary practice location

711 Bultman Drive
Sumter, SC 29150

Mailing address

711 Bultman Drive
Sumter, SC 29150
Phone (803) 773-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050919000827 SC Part B Supplier - Clinic/Group Practice 4486688504 Receives reassigned benefits from 3 practitioners
Practice locations: Manning, SC; Sumter, SC

National Provider Directory

National Provider Directory

Locations

601 S Mill St
Manning, SC 29102
Phone (803) 435-4050

608 S Mill St
Manning, SC 29102
Phone (803) 435-4050

711 Bultman Dr
Sumter, SC 29150
Phone (803) 773-3421

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1306037676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BULTMAN DRIVE",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-773-3421",
            "fax_number": "803-773-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BULTMAN DRIVE",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-773-3421",
            "fax_number": "803-773-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS HEALTH & INJURY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "FRIDAY",
        "authorized_official_first_name": "DUANGMANI",
        "authorized_official_title_or_position": "OWNER DC",
        "authorized_official_telephone_number": "803-773-3421",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1857",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1773",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "7414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.