Organization Active NPI

Cardiology Care of SC, LLC

  • Cardiovascular Disease Physician
  • Summerville, SC
National Provider Identifier
1528091584
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
11269 Issued in SC
Legal business name
CARDIOLOGY CARE OF SC, LLC
Practice address
109 Burton Ave
Suite E
Summerville, SC 29485-8117
Phone
(843) 832-6875
Fax
(843) 832-6878
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Michael Lam, MDNPI 1336190883
Title
Owner
Phone
(843) 932-6875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 11269 SC Primary

Addresses

Primary practice location

109 Burton Ave
Suite E
Summerville, SC 29485-8117

Mailing address

109 Burton Ave
Suite E
Summerville, SC 29485-8117
Phone (843) 832-6875

Other identifiers 2

IdentifierTypeStateIssuer
112693MedicaidSC
GP4326MedicaidSC

National Provider Directory

National Provider Directory

Locations

109 Burton Ave
Ste E
Summerville, SC 29485
Phone (843) 832-6875

Practitioners & affiliated clinicians

Practitioners 1

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1528091584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BURTON AVE",
            "address_2": "SUITE E",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858117",
            "telephone_number": "843-832-6875",
            "fax_number": "843-832-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BURTON AVE",
            "address_2": "SUITE E",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858117",
            "telephone_number": "843-832-6875",
            "fax_number": "843-832-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY CARE OF SC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-932-6875",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "11269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112693",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4326",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.