NPIMap

Organization Active NPI

Family Practice Clinic of Boiling Springs

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1356545768
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
072469 Issued in SC
Legal business name
FAMILY PRACTICE CLINIC OF BOILING SPRINGS
Practice address
2224 Old Furnace Rd
Spartanburg, SC 29316-5782
Phone
(864) 578-8720
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roger Dale ShealyNPI 1982639274
Title
Dr.
Phone
(864) 578-8720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 072469 SC Primary

Addresses

Primary practice location

2224 Old Furnace Rd
Spartanburg, SC 29316-5782

Mailing address

2224 Old Furnace Rd
Spartanburg, SC 29316-5782
Phone (864) 578-8720

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356545768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 OLD FURNACE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293165782",
            "telephone_number": "864-578-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 OLD FURNACE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293165782",
            "telephone_number": "864-578-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CLINIC OF BOILING SPRINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEALY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "864-578-8720",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "072469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • 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.