Peninsula ENT and Plastic Surgery, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

12840 Issued in SC

Legal business name

PENINSULA ENT AND PLASTIC SURGERY, LLC

Practice address

125 Doughty St
Suite 440
Charleston, SC 29403-5736

Phone

(843) 958-8877

Fax

(843) 958-8878

NPI assigned

Jan 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Natahsa F Glencamp

Title

Billing Specialist

Phone

(843) 958-8877

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Raymond Samuel Kaplan, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Charleston, SC
  • NPI 1669457016
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1497735997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "SUITE 440",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035736",
            "telephone_number": "843-958-8877",
            "fax_number": "843-958-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "SUITE 440",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035736",
            "telephone_number": "843-958-8877",
            "fax_number": "843-958-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA ENT AND PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "GLENCAMP",
        "authorized_official_first_name": "NATAHSA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "843-958-8877",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "12840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128409",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralitza Hristova Peneva, MD
• Peninsula Cosmetic and Family Dentistry, Inc.
• Peninsula Cosmetic and Family Dentistry, Inc.
• Peninsula Counseling Services
• Peninsula Dentistry Wappoo LLC
• Fletcher Thompson Penney, M.D.
• Megan Pennington
• Robert Pennington, DPT
• Carita Kiely Penno, PA-C
• Carley Peplowski, RN

• Specialist in Charleston, SC
• Providers in Charleston, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.