Kershawhealth

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

HTL0101 Issued in SC

Legal business name

KERSHAWHEALTH

Doing business as

Kershawhealth Surgery Associates

Practice address

1102 Roberts St
Camden, SC 29020-3734

Phone

(803) 432-7682

NPI assigned

Jun 10, 2014

Organization subpart

Yes

Parent organization

KERSHAWHEALTHAs reported in NPPES

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

Authorized official

Name

Miichael L Bunch

Title

Evp-Coo & Cfo

Phone

(803) 713-2496

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KERSHAWHEALTH SURGERY ASSOCIATES Doing business as

Part of

Kershaw County Medical

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda McKie

  • Occupational Therapist
  • Camden, SC
  • NPI 1780247221
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1457764169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203734",
            "telephone_number": "803-432-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203734",
            "telephone_number": "803-432-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAWHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KERSHAWHEALTH",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "BUNCH",
        "authorized_official_first_name": "MIICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EVP-COO & CFO",
        "authorized_official_telephone_number": "803-713-2496"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "SC",
            "license": "HTL0101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3410",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KERSHAWHEALTH SURGERY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kershaw Urology, LLC
• Kershawhealth
• Kershawhealth (Kershawhealth Primary Care at Camden)
• Kershawhealth
• Kershawhealth (Karesh Long Term Care)
• Kershawhealth (Kershawhealth Pharmacy)
• Kershawhealth (Kershawhealth Pulmonary Service)
• Kershawhealth (Kershawhealth Infectious Diseases)
• Kershawhealth
• Kershawhealth (Kershawhealthgastroenterology)

• Surgery Physician in Camden, SC
• Providers in Camden, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.