Organization Active NPI

Myers Podiatry Clinic

  • Foot & Ankle Surgery Podiatrist
  • Mullins, SC
National Provider Identifier
1487722559
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC 531 Issued in SC
Legal business name
MYERS PODIATRY CLINIC
Practice address
2845 E Highway 76
Medical Park 2, Ste 1
Mullins, SC 29574-6037
Phone
(843) 431-2780
NPI assigned
Nov 30, 2006
Organization subpart
Yes
Parent organization
MYERS PODIATRY CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Authorized official

Name
Dr. William Charles Myers Jr., DPM
Title
Owner
Phone
(843) 431-2780

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X SC 531 SC Primary
Durable Medical Equipment & Medical Supplies 332B00000X SC 531 SC

Addresses

Primary practice location

2845 E Highway 76
Medical Park 2, Ste 1
Mullins, SC 29574-6037

Mailing address

2845 E Highway 76
Medical Park 2, Ste 1
Mullins, SC 29574-6037
Phone (843) 431-2780

Other identifiers 1

IdentifierTypeStateIssuer
GP9923MedicaidSC

National Provider Directory

National Provider Directory
Part of
Myers Podiatry Clinic P

Locations

2376 Cypress Cir
Ste 201
Conway, SC 29526
Phone (843) 347-3334

2845 E Highway 76
Ste 1
Mullins, SC 29574
Phone (843) 431-2780

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1487722559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 E HIGHWAY 76",
            "address_2": "MEDICAL PARK 2, STE 1",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 E HIGHWAY 76",
            "address_2": "MEDICAL PARK 2, STE 1",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYERS PODIATRY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYERS PODIATRY CLINIC",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-431-2780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "SC 531",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "SC 531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9923",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullins, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.