Individual provider Active NPI

Wayne Gaines Entrekin, MD

  • Internal Medicine Physician
  • Aiken, SC
National Provider Identifier
1528266624
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5359 Issued in SC
Practice address
302 University Pkwy
Aiken Regional Medical Centers Dr 1117
Aiken, SC 29802-1117
Phone
(803) 641-5000
Fax
(803) 641-5690
NPI assigned
Jul 10, 2007
Last updated
Jul 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5359 SC Primary

Addresses

Primary practice location

302 University Pkwy
Aiken Regional Medical Centers Dr 1117
Aiken, SC 29802-1117

Mailing address

PO Drawer 1117
302 University Pkwy Aiken Regional Medical Centers
Aiken, SC 29802-1117
Phone (803) 641-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1528266624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 1117",
            "address_2": "302 UNIVERSITY PKWY AIKEN REGIONAL MEDICAL CENTERS",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298021117",
            "telephone_number": "803-641-5000",
            "fax_number": "803-641-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 UNIVERSITY PKWY",
            "address_2": "AIKEN REGIONAL MEDICAL CENTERS DR 1117",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298021117",
            "telephone_number": "803-641-5000",
            "fax_number": "803-641-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTREKIN",
        "first_name": "WAYNE",
        "middle_name": "GAINES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "5359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.