NPIMap

Organization Active NPI

The Pediatric Center

  • Pediatrics Physician
  • Greer, SC
National Provider Identifier
1558415844
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18570 Issued in SC
Legal business name
THE PEDIATRIC CENTER
Practice address
111 Memorial Dr
Greer, SC 29650-1518
Phone
(864) 848-7004
Fax
(864) 848-3666
NPI assigned
Jan 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Aziz Ghandnoosh, M.D.NPI 1437146628
Title
Physician
Phone
(864) 848-7005

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
Pediatrics Physician 208000000X 18570 SC Primary

Addresses

Primary practice location

111 Memorial Dr
Greer, SC 29650-1518

Mailing address

111 Memorial Dr
Greer, SC 29650-1518
Phone (864) 848-7004

Other identifiers 1

IdentifierTypeStateIssuer
T26745MedicaidSC

National Provider Directory

National Provider Directory

Locations

111 Memorial Dr
Greer, SC 29650
Phone (864) 848-7004

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558415844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MEMORIAL DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501518",
            "telephone_number": "864-848-7004",
            "fax_number": "864-848-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEMORIAL DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501518",
            "telephone_number": "864-848-7004",
            "fax_number": "864-848-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHANDNOOSH",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "864-848-7005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "18570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T26745",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.