Organization Active NPI

Merrell C. Still Jr. DMD PA

  • Dentist
  • Barnwell, SC
National Provider Identifier
1487987087
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3022 Issued in SC
Legal business name
MERRELL C. STILL JR. DMD PA
Practice address
10982 Ellenton St
Barnwell, SC 29812-7304
Phone
(803) 259-1124
Fax
(803) 259-9801
NPI assigned
Sep 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Linda S. Brown
Title
Office Manager
Phone
(803) 259-1124

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 3022 SC Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 4609 SC

Addresses

Primary practice location

10982 Ellenton St
Barnwell, SC 29812-7304

Mailing address

10982 Ellenton St
Barnwell, SC 29812-7304
Phone (803) 259-1124

Other identifiers 1

IdentifierTypeStateIssuer
Z30229MedicaidSC

National Provider Directory

National Provider Directory

Locations

10982 Ellenton St
Barnwell, SC 29812
Phone (803) 259-1124

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1487987087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10982 ELLENTON ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298127304",
            "telephone_number": "803-259-1124",
            "fax_number": "803-259-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10982 ELLENTON ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298127304",
            "telephone_number": "803-259-1124",
            "fax_number": "803-259-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRELL C. STILL JR. DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-259-1124"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "3022",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "4609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z30229",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barnwell, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.