NPIMap

Organization Active NPI

Marion Regional Healthcare System

Doing business as Marion County Surgical Center

  • Surgery Physician
  • Mullins, SC
National Provider Identifier
1376670562
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MARION REGIONAL HEALTHCARE SYSTEM
Doing business as
Marion County Surgical Center
Practice address
2835 E Highway 76
Suite 5
Mullins, SC 29574-6038
Phone
(843) 423-3739
Fax
(843) 423-4102
NPI assigned
Feb 27, 2007
Last updated
Nov 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Authorized official

Name
Harold E Tucker
Title
Chief Executive Officer
Phone
(843) 431-2405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X SC Primary

Addresses

Primary practice location

2835 E Highway 76
Suite 5
Mullins, SC 29574-6038

Mailing address

2835 E Highway 76
Suite 5
Mullins, SC 29574-6038

Other identifiers 2

IdentifierTypeStateIssuer
110338MedicaidSC
N00724MedicaidSC

Other names 1

  • Marion County Surgical Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1376670562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 E HIGHWAY 76",
            "address_2": "SUITE 5",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 E HIGHWAY 76",
            "address_2": "SUITE 5",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746038",
            "telephone_number": "843-423-3739",
            "fax_number": "843-423-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION REGIONAL HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-431-2405"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110338",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00724",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion County Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mullins, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.