Organization Active NPI

Carolina Surgery, PA

  • Surgery Physician
  • Seneca, SC
National Provider Identifier
1316919467
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22165 Issued in SC
Legal business name
CAROLINA SURGERY, PA
Practice address
109 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone
(864) 885-1978
Fax
(864) 885-1980
NPI assigned
Feb 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Authorized official

Name
Mrs. Cindy Hudson
Title
Office Manager
Phone
(864) 885-1978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 22165 SC Primary

Addresses

Primary practice location

109 Omni Dr
Suite a
Seneca, SC 29672-9448

Mailing address

PO Box 1647
Seneca, SC 29679-1647
Phone (864) 885-1978

Other identifiers 1

IdentifierTypeStateIssuer
221655MedicaidSC

National Provider Directory

National Provider Directory

Locations

11602 Lake Underhill Rd
Ste 105
Orlando, FL 32825
Phone (407) 545-2999

102 Omni Dr
#A
Seneca, SC 29672
Phone (864) 885-1978

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1316919467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296791647",
            "telephone_number": "864-885-1978",
            "fax_number": "864-885-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 OMNI DR",
            "address_2": "SUITE A",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729448",
            "telephone_number": "864-885-1978",
            "fax_number": "864-885-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-885-1978",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "SC",
            "license": "22165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221655",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.