Organization Active NPI

Mount Pleasant OB/GYN, PA

  • Specialist
  • Mt Pleasant, SC
National Provider Identifier
1548215577
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9290 Issued in SC
Legal business name
MOUNT PLEASANT OB/GYN, PA
Practice address
1400 Hospital Dr
Mt Pleasant, SC 29464-3255
Phone
(843) 884-0301
Fax
(843) 884-9620
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Mrs. Lauralee Tabakian
Title
Practice Manager
Phone
(843) 884-0301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 9290 SC Primary

Addresses

Primary practice location

1400 Hospital Dr
Mt Pleasant, SC 29464-3255

Mailing address

1400 Hospital Dr
Mt Pleasant, SC 29464-3255
Phone (843) 884-0301

Other identifiers 1

IdentifierTypeStateIssuer
GP0418MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1548215577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643255",
            "telephone_number": "843-884-0301",
            "fax_number": "843-884-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643255",
            "telephone_number": "843-884-0301",
            "fax_number": "843-884-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT PLEASANT OB/GYN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "TABAKIAN",
        "authorized_official_first_name": "LAURALEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-884-0301",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "9290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0418",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.