NPIMap

Organization Active NPI

Mid-Carolina Podiatry, Inc.

  • Customized Equipment (DME)
  • Lexington, SC
National Provider Identifier
1457543589
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
00130 Issued in SC
Legal business name
MID-CAROLINA PODIATRY, INC.
Practice address
1207 N Lake Dr
Lexington, SC 29072-7647
Phone
(803) 359-5435
Fax
(803) 359-4502
NPI assigned
Aug 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Paul R Bearden, D.P.M.
Title
President
Phone
(803) 359-5435

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 00130 SC
Customized Equipment (DME) 332BC3200X 00130 SC Primary
Prosthetic/Orthotic Supplier 335E00000X 00130 SC

Addresses

Primary practice location

1207 N Lake Dr
Lexington, SC 29072-7647

Mailing address

1207 N Lake Dr
Lexington, SC 29072-7647
Phone (803) 359-5435

Other identifiers 1

IdentifierTypeStateIssuer
18003OtherSCDMERC-PAYOR NUMBER

Other names 1

  • Lexington Foot Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1207 N Lake Dr
Lexington, SC 29072
Phone (803) 359-5435

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1457543589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727647",
            "telephone_number": "803-359-5435",
            "fax_number": "803-359-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727647",
            "telephone_number": "803-359-5435",
            "fax_number": "803-359-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CAROLINA PODIATRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-359-5435",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "SC",
            "license": "00130",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "SC",
            "license": "00130",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "00130",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC-PAYOR NUMBER",
            "identifier": "18003",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lexington Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.