Upstate Bariatrics Clinic

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

143918 Issued in SC

Legal business name

UPSTATE BARIATRICS CLINIC

Doing business as

Upstate Bariatrics clinic

Practice address

6 Halter Drive
Piedmont, SC 29673-2196

Phone

(864) 269-2400

Fax

(864) 269-2288

NPI assigned

May 15, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kurt Gandenberger

Title

Medical Doctor

Phone

(864) 269-2400

Specialties & licenses 1

Addresses

Other names 1

• Upstate Bariatrics clinic Doing business as

Locations

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1609135326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HALTER DRIVE",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296732196",
            "telephone_number": "864-269-2400",
            "fax_number": "864-269-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HALTER DRIVE",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296732196",
            "telephone_number": "864-269-2400",
            "fax_number": "864-269-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE BARIATRICS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "GANDENBERGER",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "864-269-2400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "SC",
            "license": "143918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upstate Bariatrics clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Point of Service in Piedmont, SC
• Providers in Piedmont, SC by specialty
• Point of Service in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.