NPIMap

Organization Active NPI

Adult & Pediatric Urology Center of the Carolinas PA

  • Urology Physician
  • Mullins, SC
National Provider Identifier
1528018264
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA
Practice address
2835 E Hwy 76
Suite 3
Mullins, SC 29574
Phone
(843) 423-4777
Fax
(843) 423-0802
NPI assigned
May 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Glenn Ross Gangi, MDNPI 1932176195
Title
Ceo
Phone
(843) 423-4777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

2835 E Hwy 76
Suite 3
Mullins, SC 29574

Mailing address

2835 E Hwy 76
Suite 3
Mullins, SC 29574
Phone (843) 423-4777

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528018264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 E HWY 76",
            "address_2": "SUITE 3",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "29574",
            "telephone_number": "843-423-4777",
            "fax_number": "843-423-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 E HWY 76",
            "address_2": "SUITE 3",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "29574",
            "telephone_number": "843-423-4777",
            "fax_number": "843-423-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GANGI",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-423-4777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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.