The Pediatric Care Center, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

21070 Issued in SC

Legal business name

THE PEDIATRIC CARE CENTER, LLC

Practice address

6614 Augusta Hwy
Leesville, SC 29070-9213

Phone

(803) 604-8400

Fax

(803) 604-8404

NPI assigned

Mar 1, 2017

Organization subpart

No

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

Authorized official

Name

Brandy Smith

Title

Office Manager

Phone

(803) 604-8400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1497295174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 AUGUSTA HWY",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290709213",
            "telephone_number": "803-604-8400",
            "fax_number": "803-604-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 AUGUSTA HWY",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290709213",
            "telephone_number": "803-604-8400",
            "fax_number": "803-604-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-604-8400"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "21070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Leesville, SC
• Providers in Leesville, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.