NPIMap

Organization Active NPI

Edgewater Urgent Care

  • Family Medicine Physician
  • Fort Mill, SC
National Provider Identifier
1306091301
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EDGEWATER URGENT CARE
Practice address
1162 Fort Mill Hwy
Suite a
Fort Mill, SC 29707-7511
Phone
(803) 396-7900
Fax
(803) 396-2963
NPI assigned
Nov 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Authorized official

Name
Dr. Brian A Walker, D.O.NPI 1619949617
Title
Physician/Partner
Phone
(803) 396-7900

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 1

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

Addresses

Primary practice location

1162 Fort Mill Hwy
Suite a
Fort Mill, SC 29707-7511

Mailing address

1162 Fort Mill Hwy
Suite a
Fort Mill, SC 29707-7511
Phone (803) 396-7900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1306091301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 FORT MILL HWY",
            "address_2": "SUITE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077511",
            "telephone_number": "803-396-7900",
            "fax_number": "803-396-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 FORT MILL HWY",
            "address_2": "SUITE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077511",
            "telephone_number": "803-396-7900",
            "fax_number": "803-396-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "803-396-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.