Between the Lakes Family Practice, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BETWEEN THE LAKES FAMILY PRACTICE, PA

Practice address

106 Ram Cat Aly
Seneca, SC 29678-3244

Phone

(864) 888-4445

Fax

(864) 888-4345

NPI assigned

Jan 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Mouzon Smith Jr., M.D.

Title

President

Phone

(864) 888-4445

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356312995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 RAM CAT ALY",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296783244",
            "telephone_number": "864-888-4445",
            "fax_number": "864-888-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 RAM CAT ALY",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296783244",
            "telephone_number": "864-888-4445",
            "fax_number": "864-888-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETWEEN THE LAKES FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MOUZON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-888-4445",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3282",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Seneca, SC
• Providers in Seneca, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.