NPIMap

Organization Active NPI

Oconee Physician Practices

  • Rural Health Clinic/Center
  • Seneca, SC
National Provider Identifier
1356527352
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OCONEE PHYSICIAN PRACTICES
Practice address
106 Ram Cat Aly
Seneca, SC 29678-3244
Phone
(864) 888-4445
Fax
(864) 888-4345
NPI assigned
Jan 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Authorized official

Name
Mr. Matthew G Hedtke
Title
Executive Director
Phone
(864) 885-7989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SC Primary

Addresses

Primary practice location

106 Ram Cat Aly
Seneca, SC 29678-3244

Mailing address

301 Memorial Dr
Seneca, SC 29672-9491
Phone (864) 885-7989

Other identifiers 1

IdentifierTypeStateIssuer
GP4697MedicaidSC

Other names 1

  • Between the LakesPrimary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clemson-Seneca Pediatrics6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 Ram Cat Aly
Seneca, SC 29678
Phone (864) 888-4445

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200873600000",
    "number": "1356527352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729491",
            "telephone_number": "864-885-7989",
            "fax_number": "864-445-7945"
        },
        {
            "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": "OCONEE PHYSICIAN PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-01-21",
        "status": "A",
        "authorized_official_last_name": "HEDTKE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-885-7989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4697",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Between the LakesPrimary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 21, 2008; 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.