Berkeley Medical Center, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BERKELEY MEDICAL CENTER, LLC

Practice address

106 W Main St
Moncks Corner, SC 29461-2601

Phone

(843) 761-1995

Fax

(843) 761-3257

NPI assigned

Nov 14, 2007

Last updated

Mar 28, 2016By 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

Dr. Rose D. GibbsNPI 1548299159

Title

Medical Doctor

Phone

(843) 761-1995

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Rose Delores Gibbs, MD

  • Internal Medicine Physician
  • Moncks Corner, SC
  • NPI 1548299159
  Authorized official Same address or phone
• Valarie R. Madison

  • Health Educator
  • Moncks Corner, SC
  • NPI 1235946120
  NPD

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1417137803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612601",
            "telephone_number": "843-761-1995",
            "fax_number": "843-761-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612601",
            "telephone_number": "843-761-1995",
            "fax_number": "843-761-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "843-761-1995",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC038",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Berkeley County Schools
• Berkeley Family Dentistry LLC
• Berkeley Family Practice LLC
• Berkeley Home Clinic
• Berkeley Home Pharmacy LLC (Berkeley Home Pharmacy)
• Berkeley Prosthetic Laboratory LLC
• Berkeley Seniors Inc
• Berkeley Treatment Center LLC
• Erin M Berkey, LPC
• Berry Massagetherapy & Chiropractic Center

• Internal Medicine Physician in Moncks Corner, SC
• Providers in Moncks Corner, 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 Mar 28, 2016; 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.