Organization Active NPI

Mante Pediatrics of Rock Hill Inc.

  • Primary Care Clinic/Center
  • Rock Hill, SC
National Provider Identifier
1316369556
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
29696 Issued in SC
Legal business name
MANTE PEDIATRICS OF ROCK HILL INC.
Practice address
1626 Cranium Dr
Suite 103
Rock Hill, SC 29732-3506
Phone
(803) 980-5700
Fax
(803) 980-5702
NPI assigned
Jan 7, 2014
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Mrs. Patience Mante
Title
Administrator
Phone
(803) 313-3846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 29696 SC Primary

Addresses

Primary practice location

1626 Cranium Dr
Suite 103
Rock Hill, SC 29732-3506

Mailing address

1626 Cranium Dr
Suite 103
Rock Hill, SC 29732-3506
Phone (803) 980-5700

Other identifiers 1

IdentifierTypeStateIssuer
296968MedicaidSC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2073985Mante Pediatrics of Rock Hill Inc1626 Cranium Drive Ste 103, Rock Hill, SC 29732Certificate of waiverFeb 26, 2028

National Provider Directory

National Provider Directory

Locations

1626 Cranium Dr
Ste 103
Rock Hill, SC 29732
Phone (803) 980-5700

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1316369556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 CRANIUM DR",
            "address_2": "SUITE 103",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323506",
            "telephone_number": "803-980-5700",
            "fax_number": "803-980-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 CRANIUM DR",
            "address_2": "SUITE 103",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323506",
            "telephone_number": "803-980-5700",
            "fax_number": "803-980-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTE PEDIATRICS OF ROCK HILL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "MANTE",
        "authorized_official_first_name": "PATIENCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "803-313-3846",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "29696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296968",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.