Organization Active NPI

Pee Dee OBGYN Assoc., PA

  • Obstetrics & Gynecology Physician
  • Mullins, SC
National Provider Identifier
1497816672
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
8727 Issued in SC
Legal business name
PEE DEE OBGYN ASSOC., PA
Practice address
2845 E Highway 76
Medical Park 2 Suite 2
Mullins, SC 29574-6037
Phone
(843) 431-2740
Fax
(843) 431-2197
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ernest E Murray, MD
Title
President
Phone
(843) 431-2740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 8727 SC Primary

Addresses

Primary practice location

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

Mailing address

2845 East Hwy 76
Medical Park 2 Suite 2
Mullins, SC 29574-6037
Phone (843) 431-2740

Other identifiers 5

IdentifierTypeStateIssuer
9630895OtherSCUNITED HEALTHCARE
02375OtherNCOFFICE IDENTIFIER
PA1872MedicaidSC
20000382OtherSCSELECT HEALTH
8902375OtherNCOFFICE IDENTIFIER

National Provider Directory

National Provider Directory

Locations

1311 N Main St
Marion, SC 29571
Phone (843) 423-7382

2845 E Highway 76
Ste 2
Mullins, SC 29574
Phone (843) 431-2730

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497816672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 EAST HWY 76",
            "address_2": "MEDICAL PARK 2 SUITE 2",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2740",
            "fax_number": "843-431-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 E HIGHWAY 76",
            "address_2": "MEDICAL PARK 2 SUITE 2",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2740",
            "fax_number": "843-431-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE DEE OBGYN ASSOC., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-431-2740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "8727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "9630895",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE IDENTIFIER",
            "identifier": "02375",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA1872",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "20000382",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE IDENTIFIER",
            "identifier": "8902375",
            "state": "NC"
        }
    ],
    "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 Aug 22, 2020; 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.