Indian Land Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

INDIAN LAND PEDIATRICS, LLC

Practice address

7580 Charlotte Hwy
Suite 1000
Fort Mill, SC 29707-7801

Phone

(803) 396-1090

Fax

(803) 396-1091

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Lucretia Ann Carter, MD

Title

Owner

Phone

(803) 396-1090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1306118583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 1000",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-396-1090",
            "fax_number": "803-396-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 1000",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-396-1090",
            "fax_number": "803-396-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN LAND PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LUCRETIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-396-1090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.