Active NPI
Carolina Urology Center, PA
- Urology Physician
- Rock Hill, SC
National Provider Identifier
1366467250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- CAROLINA UROLOGY CENTER, PA
- Practice address
- 1780 Medical Park Dr
Rock Hill, SC 29732-1194 - Phone
- (803) 327-1116
- Fax
- (803) 327-6872
- NPI assigned
- Jul 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tracy Black
- Title
- Practice Manager
- Phone
- (803) 327-1116
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
1780 Medical Park Dr
Rock Hill, SC 29732-1194
Mailing address
1780 Medical Park Dr
Rock Hill, SC 29732-1194
Phone (803) 327-1116
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02555 | Other | NC | BCBS |
| PA4307 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000
580 Kingsley Park Dr
Ste 150
Fort Mill, SC 29715
Phone (803) 578-7600
1077 W Meeting St
#A
Lancaster, SC 29720
Phone (803) 285-1337
Practitioners & affiliated clinicians
Practitioners 6
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": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1191888000000",
"number": "1366467250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1780 MEDICAL PARK DR",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321194",
"telephone_number": "803-327-1116",
"fax_number": "803-327-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 MEDICAL PARK DR",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321194",
"telephone_number": "803-327-1116",
"fax_number": "803-327-6872"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROLINA UROLOGY CENTER, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-13",
"last_updated": "2007-10-09",
"status": "A",
"authorized_official_last_name": "BLACK",
"authorized_official_first_name": "TRACY",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "803-327-1116"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02555",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA4307",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
- Carolina Solution Inc.
- Carolina Stateline Counseling LLC
- Carolina Targeted Case Management,LLC
- Carolina Therapeutic Services, Inc
- Carolina Therapy Solutions for Kids, LLC
- Carolina Urology Partners, PLLC
- Carolina Vascular Surgery, LLC
- Carolinas Ambulatory Surgery Inc.
- Carolinas Caregivers Enterprises, LLC
- Carolinas Diagnostic Imaging LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.