NPIMap

Organization Active NPI

Hardeeville Medical Group, LLC

Doing business as Island Podiatry

  • Podiatrist
  • Beaufort, SC
National Provider Identifier
1609245737
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
HARDEEVILLE MEDICAL GROUP, LLC
Doing business as
Island Podiatry
Practice address
3 Celadon Dr
Suite a
Beaufort, SC 29907-2695
Phone
(843) 705-8888
Fax
(843) 705-7024
NPI assigned
Sep 18, 2015
Last updated
Jun 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Mr. Wesley O. James
Title
Regional Cfo, Tenet
Phone
(404) 265-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

3 Celadon Dr
Suite a
Beaufort, SC 29907-2695

Mailing address

PO Box 405479
Atlanta, GA 30384-5479
Phone (843) 705-8888

Other names 1

  • Island Podiatry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1609245737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405479",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845479",
            "telephone_number": "843-705-8888",
            "fax_number": "843-705-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CELADON DR",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072695",
            "telephone_number": "843-705-8888",
            "fax_number": "843-705-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARDEEVILLE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "REGIONAL CFO, TENET",
        "authorized_official_telephone_number": "404-265-5009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.