NPIMap

Organization Active NPI

Sumter OBGYN PA

  • Obstetrics & Gynecology Physician
  • Sumter, SC
National Provider Identifier
1528037850
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SUMTER OBGYN PA
Practice address
115 N Sumter St
Suite 200
Sumter, SC 29150-4972
Phone
(803) 775-8351
Fax
(803) 773-2635
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Mrs. Tracie Scurry
Title
Credentialing/Ins/Billing
Phone
(803) 775-8351

Specialties & licenses 1

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

Addresses

Primary practice location

115 N Sumter St
Suite 200
Sumter, SC 29150-4972

Mailing address

PO Box 1469
Sumter, SC 29151-1469
Phone (803) 775-8351

Other identifiers 1

IdentifierTypeStateIssuer
PA1346MedicaidSC

National Provider Directory

National Provider Directory

Locations

115 N Sumter St
Ste 200
Sumter, SC 29150
Phone (803) 775-8351

Practitioners & affiliated clinicians

Practitioners 5

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": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1528037850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1469",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291511469",
            "telephone_number": "803-775-8351",
            "fax_number": "803-773-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N SUMTER ST",
            "address_2": "SUITE 200",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504972",
            "telephone_number": "803-775-8351",
            "fax_number": "803-773-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER OBGYN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "SCURRY",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "CREDENTIALING/INS/BILLING",
        "authorized_official_telephone_number": "803-775-8351",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA1346",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.