NPIMap

Organization Active NPI

Camden Bone & Joint LLC

  • Orthopaedic Surgery Physician
  • Camden, SC
National Provider Identifier
1497783880
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CAMDEN BONE & JOINT LLC
Practice address
1112 Mill St
Camden, SC 29020
Phone
(803) 432-4498
Fax
(803) 425-4123
NPI assigned
Jun 28, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kathy S Parker
Title
Office Manager
Phone
(803) 432-4498

Practitioners 8

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031203000008 SC Part B Supplier - Clinic/Group Practice 3375448442 Receives reassigned benefits from 8 practitioners
Practice locations: Camden, SC
O20100930069611 SC DME Supplier - Physician - Orthopedic/Orthopedic Surgery
DME Supplier - Sports Medicine		 3375448442 Practice locations: Camden, SC

National Provider Directory

Locations

1112 Mill St
Camden, SC 29020
Phone (803) 432-4498

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1112 Mill St
Camden, SC 29020

Mailing address

1112 Mill St
Camden, SC 29020
Phone (803) 432-4498

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
473807MedicaidSC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2012.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1497783880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 MILL ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "29020",
            "telephone_number": "803-432-4498",
            "fax_number": "803-425-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 MILL ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "29020",
            "telephone_number": "803-432-4498",
            "fax_number": "803-425-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN BONE & JOINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-432-4498"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473807",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.