Individual provider Active NPI

Harry Wells Floyd, MD

  • General Practice Physician
  • Kingstree, SC
National Provider Identifier
1356489579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5526 Issued in SC
Practice address
500 Thurgood Marshall Blvd
Suite F
Kingstree, SC 29556
Phone
(843) 355-7461
Fax
(843) 355-3616
NPI assigned
Feb 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5526 SC Primary

Addresses

Primary practice location

500 Thurgood Marshall Blvd
Suite F
Kingstree, SC 29556

Mailing address

500 Thurgood Marshall Blvd
Suite F
Kingstree, SC 29556
Phone (843) 355-7461

Other identifiers 3

IdentifierTypeStateIssuer
055264MedicaidSC
PA7215MedicaidSC
RHC103MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5526SCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356489579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 THURGOOD MARSHALL BLVD",
            "address_2": "SUITE F",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "29556",
            "telephone_number": "843-355-7461",
            "fax_number": "843-355-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 THURGOOD MARSHALL BLVD",
            "address_2": "SUITE F",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "29556",
            "telephone_number": "843-355-7461",
            "fax_number": "843-355-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "HARRY",
        "middle_name": "WELLS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "5526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055264",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA7215",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC103",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingstree, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.