Upstate Pediatric Mobility

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

UPSTATE PEDIATRIC MOBILITY

Practice address

114 Lemon Tree TRL
Laurens, SC 29360-3908

Phone

(803) 307-1582

NPI assigned

Oct 10, 2025

Organization subpart

No

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

Authorized official

Name

Charles Baco

Title

Co-Owner

Phone

(864) 535-2531

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1376419010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 LEMON TREE TRL",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603908",
            "telephone_number": "864-535-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LEMON TREE TRL",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603908",
            "telephone_number": "803-307-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PEDIATRIC MOBILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-10",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "BACO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "864-535-2531"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portia Tucker
• Lakeisha Turner, FNP
• Lauren Allen Turner, SLP
• Susan Raines Turner, MSN, RN
• Stephanie Jill Ungaro, COTA
• Upstate Podiatry Group
• Upstate Podiatry Group, PA
• Alecia Van Strien
• Thinh Vo
• Miriam Elizabeth Wagner, MS CCC-SLP

• Durable Medical Equipment & Medical Supplies in Laurens, SC
• Providers in Laurens, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.