Terry Reardon MD, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21368 Issued in SC

Legal business name

TERRY REARDON MD, P.C.

Practice address

600 N Azalea Dr Ste 104
Surfside Beach, SC 29575-5020

Phone

(843) 360-2776

Fax

(877) 905-5374

NPI assigned

Mar 10, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Terry Joe Reardon, MDNPI 1518961028

Title

President

Phone

(843) 360-1285

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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.

• Terry J Reardon

  • Internal Medicine Physician
  • Pawley's Island, SC
  • NPI 1518961028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1520640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1609379114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N AZALEA DR STE 104",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755020",
            "telephone_number": "843-360-2776",
            "fax_number": "877-905-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N AZALEA DR STE 104",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755020",
            "telephone_number": "843-360-2776",
            "fax_number": "877-905-5374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Orange St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403542",
            "country_code": "US",
            "telephone_number": "843-360-2776",
            "fax_number": "877-905-5374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TERRY REARDON MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-10",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-360-1285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Surfside Beach, SC
• Providers in Surfside Beach, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.