Valcourt Pediatric Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

29352 Issued in SC

Legal business name

VALCOURT PEDIATRIC ASSOCIATES

Practice address

124 Medical Park Dr
Walterboro, SC 29488-5719

Phone

(843) 782-3636

Fax

(843) 782-3269

NPI assigned

Nov 22, 2011

Last updated

Nov 22, 2011By 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

Ms. Lisa Maree Hart

Title

Practice Adminstrator

Phone

(843) 782-3636

Specialties & licenses 1

Addresses

Other identifiers 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.

• Quan Johnson, MD

  • Pediatrics Physician
  • Grovetown, GA
  • NPI 1699932418
  NPD (past)

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1396012126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MEDICAL PARK DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885719",
            "telephone_number": "843-782-3636",
            "fax_number": "843-782-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MEDICAL PARK DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885719",
            "telephone_number": "843-782-3636",
            "fax_number": "843-782-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALCOURT PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MAREE",
        "authorized_official_title_or_position": "PRACTICE  ADMINSTRATOR",
        "authorized_official_telephone_number": "843-782-3636",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "29352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G58526",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• True Beginnings LLC
• Nicole E Trumbull, OTR/L
• Meagan Tyler
• United Rehab Inc. (United Rehab of Walterboro)
• Alyssa W Ursini, FNP
• Yvrose Valcourt, MD
• Kathryn Anne Vanravenstein, A.P.R.N.
• Josh Vigder
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1358)
• Wal-Mart Stores East, LP (Vision center 30-1358)

• Pediatrics Physician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.