Pura Plastic Surgery

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

33186 Issued in SC

Legal business name

PURA PLASTIC SURGERY

Practice address

5351 Sunset Blvd
Lexington, SC 29072-9159

Phone

(803) 490-7644

Fax

(803) 490-7645

NPI assigned

Feb 22, 2016

Last updated

Jan 13, 2017By 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

Oliver Pope Simmons, MD

Title

Owner

Phone

(803) 421-9208

Specialties & licenses 6

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1447619218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5351 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729159",
            "telephone_number": "803-490-7644",
            "fax_number": "803-490-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5351 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729159",
            "telephone_number": "803-490-7644",
            "fax_number": "803-490-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "POPE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-421-9208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "SC",
            "license": "33186",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "SC",
            "license": "33186",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "SC",
            "license": "33186",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "33186",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": "SC",
            "license": "33186",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "SC",
            "license": "33186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331867",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• Plastic and Reconstructive Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.