NPIMap

Organization Active NPI

Kershawhealth

Doing business as Kershawhealth Pulmonary Service

  • Pulmonary Disease Physician
  • Camden, SC
National Provider Identifier
1528203205
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
KERSHAWHEALTH
Doing business as
Kershawhealth Pulmonary Service
Practice address
1218 Roberts St
Camden, SC 29020-3736
Phone
(803) 425-6460
Fax
(803) 425-6477
NPI assigned
Dec 9, 2008
Organization subpart
Yes
Parent organization
KERSHAW HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Authorized official

Name
Donnie J Weeks
Title
Ceo
Phone
(803) 713-2065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1218 Roberts St
Camden, SC 29020-3736

Mailing address

1315 Roberts St
Camden, SC 29020-3737

Other identifiers 3

IdentifierTypeStateIssuer
328735MedicaidSC
369382MedicaidSC
400480MedicaidSC

Other names 1

  • KERSHAWHEALTH PULMONARY SERVICE Doing business as

National Provider Directory

National Provider Directory
Part of
Kershaw County Medical

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1528203205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203736",
            "telephone_number": "803-425-6460",
            "fax_number": "803-425-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAWHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KERSHAW HEALTH",
        "enumeration_date": "2008-12-09",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "DONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-713-2065"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328735",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369382",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KERSHAWHEALTH PULMONARY SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.