Southeast Neuropathy & Treatment Center, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

SOUTHEAST NEUROPATHY & TREATMENT CENTER, LLC

Practice address

1494 Lake Murray Blvd
1St Floor
Columbia, SC 29212-8697

Phone

(803) 240-5399

Fax

(803) 791-1634

NPI assigned

Mar 7, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Glenn Gray

Title

Corporate Compliance Officer

Phone

(803) 240-5399

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clarence Stewart Darby, PA PHD

  • Medical Physician Assistant
  • Columbia, SC
  • NPI 1073535605
  NPD (past)
• Angela Hampton, PA-C

  • Physician Assistant
  • Bamberg, SC
  • NPI 1568586790
  NPD (past)
• Torianne Miranda Yetter, PA

  • Physician Assistant
  • Conowingo, MD
  • NPI 1760851299
  NPD (past)

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1396161808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290630026",
            "telephone_number": "803-240-5399",
            "fax_number": "803-791-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1494 LAKE MURRAY BLVD",
            "address_2": "1ST FLOOR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128697",
            "telephone_number": "803-240-5399",
            "fax_number": "803-791-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST NEUROPATHY & TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "803-240-5399",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Youth Advocate Program
• South Carolina Youth Advocate Program
• South Carolina Youth Advocate Program
• Southeast Center for Family Development & Institute for Family Enrichm
• Southeast Counseling & Consulting, LLC
• Southeast Therapy LLC
• Southeastern Chiropractic Center P C
• Southeastern Ear Nose Throat Allergy and Sleep Disorders Institute
• Southeastern Health Care Group LLC
• Southeastern Medical Brokers, Inc.

• Pain Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Pain Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.