NPIMap

Organization Active NPI

Med Central Health Resources, Inc

  • Adult Medicine Physician
  • Anderson, SC
National Provider Identifier
1528028727
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
MED CENTRAL HEALTH RESOURCES, INC
Practice address
3424 Clemson Blvd
Anderson, SC 29621-1357
Phone
(864) 261-3022
Fax
(864) 224-5990
NPI assigned
Mar 23, 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. Jerry M. Neal, PHD.
Title
President
Phone
(864) 261-3022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

3424 Clemson Blvd
Anderson, SC 29621-1357

Mailing address

3424 Clemson Blvd
Anderson, SC 29621-1357
Phone (864) 261-3022

Other identifiers 1

IdentifierTypeStateIssuer
GP0205MedicaidSC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0252773Med Central Health Resources Inc3424 Clemson Blvd, Anderson, SC 29621Provider-performed microscopySep 26, 2027

National Provider Directory

National Provider Directory

Locations

3424 Clemson Blvd
Anderson, SC 29621
Phone (834) 261-4350

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528028727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211357",
            "telephone_number": "864-261-3022",
            "fax_number": "864-224-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211357",
            "telephone_number": "864-261-3022",
            "fax_number": "864-224-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CENTRAL HEALTH RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-261-3022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0205",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.