NPIMap

Organization Active NPI

Cannon Memorial Hospital

Doing business as Cannon Family Practice - Pendleton Street

  • Family Medicine Physician
  • Pickens, SC
National Provider Identifier
1497910772
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CANNON MEMORIAL HOSPITAL
Doing business as
Cannon Family Practice - Pendleton Street
Practice address
865 Pendleton St
Pickens, SC 29671-2578
Phone
(864) 878-4639
NPI assigned
Jul 25, 2008
Last updated
Feb 12, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
CANNON MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Authorized official

Name
Mr. Norman G Rentz
Title
Ceo
Phone
(864) 878-4791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

865 Pendleton St
Pickens, SC 29671-2578

Mailing address

PO Box 919
Pickens, SC 29671-0919
Phone (864) 897-8286

Other names 1

  • Cannon Family Practice - Pendleton Street Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cannon Memorial Hospital13 organizations share this tax ID, including this one
Part of
Cannon Memorial Hospital

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

865 Pendleton St
Pickens, SC 29671
Phone (864) 878-4639

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1497910772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296710919",
            "telephone_number": "864-897-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 PENDLETON ST",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712578",
            "telephone_number": "864-878-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CANNON MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-25",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "RENTZ",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-878-4791",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cannon Family Practice - Pendleton Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pickens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.