Organization Active NPI

New Haven Medical Services, P.a.

  • Infectious Disease Physician
  • Seneca, SC
National Provider Identifier
1609821602
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
NEW HAVEN MEDICAL SERVICES, P.A.
Practice address
115 Eagles Nest Dr
Suite B
Seneca, SC 29678-2762
Phone
(864) 885-2000
Fax
(864) 885-1004
NPI assigned
May 24, 2006
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. Peter Kennedy Kwofie, M.D.NPI 1124002118
Title
Physician Owner
Phone
(864) 885-2000

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
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

115 Eagles Nest Dr
Suite B
Seneca, SC 29678-2762

Mailing address

115 Eagles Nest Dr
Suite B
Seneca, SC 29678-2762
Phone (864) 885-2000

Other identifiers 1

IdentifierTypeStateIssuer
GP4100MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050321000631 SC Part B Supplier - Clinic/Group Practice 9638124886 Receives reassigned benefits from 2 practitioners
Practice locations: Seneca, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1037951New Haven Medical Services PA115 Eagles Nest Drive, Suite B, Seneca, SC 29678Certificate of waiverMar 7, 2027

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609821602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EAGLES NEST DR",
            "address_2": "SUITE B",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782762",
            "telephone_number": "864-885-2000",
            "fax_number": "864-885-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EAGLES NEST DR",
            "address_2": "SUITE B",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782762",
            "telephone_number": "864-885-2000",
            "fax_number": "864-885-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN MEDICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KWOFIE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "KENNEDY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "864-885-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4100",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.