NPIMap

Organization Active NPI

Carolina Podiatry Group, Inc.

  • Podiatrist
  • Winnsboro, SC
National Provider Identifier
1427181023
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
CAROLINA PODIATRY GROUP, INC.
Practice address
102 Hwy 321 Bypass North
Winnsboro, SC 29180
Phone
(800) 336-1279
Fax
(803) 283-9920
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Dr. Brandon S Percival, D.P.M.NPI 1518930817
Title
Podiatrist
Phone
(803) 285-1411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

102 Hwy 321 Bypass North
Winnsboro, SC 29180

Mailing address

PO Box 325
Lancaster, SC 29721-0325
Phone (803) 285-1411

Other identifiers 3

IdentifierTypeStateIssuer
GP9980MedicaidSC
PD5408MedicaidSC
PD5364MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1427181023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297210325",
            "telephone_number": "803-285-1411",
            "fax_number": "800-328-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HWY 321 BYPASS NORTH",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "29180",
            "telephone_number": "800-336-1279",
            "fax_number": "803-283-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PODIATRY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "PERCIVAL",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "803-285-1411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9980",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5408",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5364",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.