Active NPI
Reginald S Bolick, MD
- Surgery Physician
- Florence, SC
National Provider Identifier
1427021963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 7550
- Practice address
- 800 E Cheves St
Ste 260
Florence, SC 29506-2652 - Phone
- (843) 665-7941
- Fax
- (843) 665-1257
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 7550 | SC | Primary |
Addresses
Primary practice location
800 E Cheves St
Ste 260
Florence, SC 29506-2652
Mailing address
PO Box 3239
Florence, SC 29502-3239
Phone (843) 665-7941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 158377 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7550 | SC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238025600000",
"number": "1427021963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3239",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295023239",
"telephone_number": "843-665-7941",
"fax_number": "843-665-1257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E CHEVES ST",
"address_2": "STE 260",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062652",
"telephone_number": "843-665-7941",
"fax_number": "843-665-1257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLICK",
"first_name": "REGINALD",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2009-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "7550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158377",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.