Carolina Oms LLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

CAROLINA OMS LLC

Practice address

105 Ben Casey Dr Ste 115
Fort Mill, SC 29708-8557

Phone

(803) 548-9910

Fax

(803) 548-9915

NPI assigned

May 19, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Nicholas Wegner, DMDNPI 1760919849

Title

Surgeon/Co-Owner

Phone

(803) 548-9910

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 2

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

• Kenneth M. Burtner, DMD

  • Oral and Maxillofacial Pathology Dentistry
  • Fort Mill, SC
  • NPI 1801976162
  Medicare reassignment NPD
• Nicholas Wegner, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1760919849

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1487345344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR STE 115",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088557",
            "telephone_number": "803-548-9910",
            "fax_number": "803-548-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR STE 115",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088557",
            "telephone_number": "803-548-9910",
            "fax_number": "803-548-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA OMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WEGNER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SURGEON/CO-OWNER",
        "authorized_official_telephone_number": "803-548-9910",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENNETH BURTNER",
            "identifier": "1801976162",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Integrated Medicine LLC
• Carolina Interventional Pain Associates, P.a
• Carolina Interventional Pain Associates, PA
• Carolina Medical Partners PLLC
• Carolina Medical Spas PA
• Carolina Oral & Maxillofacial Surgery
• Carolina Orthopaedic Surgery Associates, P.a.
• Carolina Podiatry Group, Inc.
• Carolina Professional Dentistry,LLC
• Carolina Speech Connection, LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.