Active NPI
Charles William MC Rae, M.D.
- Specialist
- Marion, SC
National Provider Identifier
1467559153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5972
- Practice address
- 302 Oliver St
Marion, SC 29571-2338 - Phone
- (843) 423-4767
- Fax
- (843) 423-1080
- NPI assigned
- Sep 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5972 | SC | Primary |
Addresses
Primary practice location
302 Oliver St
Marion, SC 29571-2338
Mailing address
302 Oliver St
Marion, SC 29571-2338
Phone (843) 423-4767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059723 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5972 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lagrange Troup County Hospital Authority | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba West Georgia Medical Center
- General Acute Care Hospital
- Lagrange, GA
- NPI 1992779748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467559153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 OLIVER ST",
"city": "MARION",
"state": "SC",
"postal_code": "295712338",
"telephone_number": "843-423-4767",
"fax_number": "843-423-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 OLIVER ST",
"city": "MARION",
"state": "SC",
"postal_code": "295712338",
"telephone_number": "843-423-4767",
"fax_number": "843-423-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MC RAE",
"first_name": "CHARLES",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "5972",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "059723",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, SC
- Marion School District One
- Marion-Dillon County Board of Disabilities and Special Needs
- Marlboro County Rescue Squad Inc (Palmetto Transport Systems)
- Aimee Wiggins Martin, FNP
- Rachel J. Mason, ED.D.
- Tiffany Antionette McBride
- Natalie McDaniel, M.S.
- Davet McFadden, MASTER
- McGill Medical Transport
- Breian McKoy Lee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.