Kershaw Cnty Psych LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

28478 Issued in SC

Legal business name

KERSHAW CNTY PSYCH LLC

Practice address

2039 West Dekalb
Building 1 Suite 1
Camden, SC 29020-2092

Phone

(800) 599-7183

Fax

(803) 788-9564

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sudhakar Reddy Morthala, MD

Title

Owner

Phone

(800) 599-7183

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1366559395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 WEST DEKALB",
            "address_2": "BUILDING 1 SUITE 1",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290202092",
            "telephone_number": "800-599-7183",
            "fax_number": "803-788-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 WEST DEKALB",
            "address_2": "BUILDING 1 SUITE 1",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290202092",
            "telephone_number": "800-599-7183",
            "fax_number": "803-788-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW CNTY PSYCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MORTHALA",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-599-7183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "28478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Eugene Kalutz, MD
• Whitney R Keen
• Susan Jane Kelly-Lowery
• Amanda Kendall, MCD,CCC-SLP
• Kershaw Anesthesia, LLC
• Kershaw County Adult Day Care Center
• Kershaw County Board of Disabilities and Special Needs
• Kershaw County Commission on Alcohol and Drug Abuse
• Kershaw County Commission on Alcohol and Drug Abuse (ALPHA Behavioral Health Center)
• Kershaw County School District

• Psychiatry Physician in Camden, SC
• Providers in Camden, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.