NPIMap

Organization Active NPI

Oconee Physician Practices

Doing business as Between the Lakes Primary Care

  • Primary Care Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1407034127
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
261QR1300X Issued in SC
Legal business name
OCONEE PHYSICIAN PRACTICES
Doing business as
Between the Lakes Primary Care
Practice address
106 Ram Cat Aly
Seneca, SC 29678-3244
Phone
(864) 888-4445
Fax
(864) 888-4345
NPI assigned
Feb 5, 2008
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Mr. Matthew G Hedtke, MHA
Title
Executive Director
Phone
(864) 885-7673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 261QR1300X SC Primary

Addresses

Primary practice location

106 Ram Cat Aly
Seneca, SC 29678-3244

Mailing address

123 Lila Doyle Dr
Seneca, SC 29672-9495
Phone (864) 885-7989

Other names 1

  • Between the Lakes Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clemson-Seneca Pediatrics6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 Lila Doyle Dr
Seneca, SC 29672

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1407034127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 LILA DOYLE DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729495",
            "telephone_number": "864-885-7989",
            "fax_number": "864-885-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 RAM CAT ALY",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296783244",
            "telephone_number": "864-888-4445",
            "fax_number": "864-888-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCONEE PHYSICIAN PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "HEDTKE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-885-7673",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "261QR1300X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Between the Lakes Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.