Organization Active NPI

Piedmont Family Practice LLC

  • General Practice Physician
  • Piedmont, SC
National Provider Identifier
1437208790
Registry record updated Apr 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PIEDMONT FAMILY PRACTICE LLC
Practice address
115 Beattie Park Rd
Piedmont, SC 29673-1410
Phone
(864) 845-3331
Fax
(864) 845-7078
NPI assigned
Jan 9, 2007
Last updated
Apr 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2018

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

Authorized official

Name
Elaine Lindsay Sloan
Title
Practice Administrator
Phone
(864) 845-3331

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

115 Beattie Park Rd
Piedmont, SC 29673-1410

Mailing address

115 Beattie Park Rd
Piedmont, SC 29673-1410
Phone (864) 845-3331

Other identifiers 1

IdentifierTypeStateIssuer
GP3020MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000311 SC Part B Supplier - Clinic/Group Practice 2466487947 Receives reassigned benefits from 7 practitioners
Practice locations: Piedmont, SC

National Provider Directory

National Provider Directory

Locations

209 Patewood Dr
Ste 200
Greenville, SC 29615
Phone (864) 234-9900

115 Beattie Park Rd
Ste 1
Piedmont, SC 29673

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17492/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524873600000",
    "number": "1437208790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BEATTIE PARK RD",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296731410",
            "telephone_number": "864-845-3331",
            "fax_number": "864-845-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BEATTIE PARK RD",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296731410",
            "telephone_number": "864-845-3331",
            "fax_number": "864-845-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-04-28",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "LINDSAY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-845-3331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3020",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.