Paul R Ponnaiya MD a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PAUL R PONNAIYA MD A PROFESSIONAL CORPORATION

Practice address

1795 Dr Frank Gaston Blvd
Rock Hill, SC 29732-1190

Phone

(702) 256-3637

NPI assigned

Sep 11, 2013

Last updated

Aug 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul R Ponnaiya, MDNPI 1528059672

Title

President

Phone

(702) 388-9777

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul R Ponnaiya, M.D.

  • Internal Medicine Physician
  • Rock Hill, SC
  • NPI 1528059672
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1386079184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174440",
            "telephone_number": "702-256-3637",
            "fax_number": "702-405-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 DR FRANK GASTON BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321190",
            "telephone_number": "702-256-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R PONNAIYA MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-11",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "PONNAIYA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-388-9777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Patterson
• Elizabeth Patterson, BCBA
• Kenneth Thomas Patterson, MD
• Kevin Patton
• Catherine Ann Paukovitz, D.P.M.
• Celeste Bien Paul, OTRL
• Courtney Joanne Pavlovich, LPTA
• Carlos Andres Paxtor, FNP
• Carlos G Paxtor, M.D.
• Danielle Gloria Payne, PHARMD

• Internal Medicine Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.