Edisto OBGYN PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

07054 Issued in SC

Legal business name

EDISTO OBGYN PA

Practice address

1175 Cook Rd
Suite 305
Orangeburg, SC 29118

Phone

(803) 536-9390

Fax

(803) 533-0911

NPI assigned

May 23, 2006

Last updated

Jan 9, 2008By 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

Dr. Jerome B Degen, MDNPI 1669654448

Title

President

Phone

(803) 536-9390

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Jerome B Degen, MD

  • Obstetrics & Gynecology Physician
  • Orangeburg, SC
  • NPI 1669654448
  Authorized official Same address or phone

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1467407155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 305",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "29118",
            "telephone_number": "803-536-9390",
            "fax_number": "803-533-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 305",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "29118",
            "telephone_number": "803-536-9390",
            "fax_number": "803-533-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO OBGYN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "DEGEN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-536-9390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "07054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070540",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Easterling, RN,MSN,APRN,PMHNP-BC
• Sharon Inabinet Eden, M.D.
• James Patrick Edens II, CRNA
• Edisto Dental Associates LLC
• Edisto Home Care & Hospice, LLC
• Edisto Regional Health Services (Copeland Medical Care)
• Edisto Regional Health Services (James H. Brunson, Jr, MD)
• Edisto Regional Health Services (Edisto Regional Pediatrics)
• Edisto Regional Health Services Inc (RMC Express Care)
• Edisto Regional Health Services Inc. (Edisto Family Practice)

• Obstetrics & Gynecology Physician in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Obstetrics & Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.