Organization Active NPI

Carolina Internal Medicine PA

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1609986769
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7609 Issued in SC
Legal business name
CAROLINA INTERNAL MEDICINE PA
Practice address
1208 Augusta Street
Greenville, SC 29611
Phone
(864) 271-3930
Fax
(864) 232-2384
NPI assigned
Aug 30, 2006
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Sudhirkumar Patel, MDNPI 1962590539
Title
Owner
Phone
(864) 271-3930

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14686 SC
Internal Medicine Physician 207R00000X 19946 SC
Internal Medicine Physician 207R00000X 7609 SC Primary

Addresses

Primary practice location

1208 Augusta Street
Greenville, SC 29611

Mailing address

1208 Augusta St
Greenville, SC 29605-4024
Phone (864) 271-3930

Other identifiers 1

IdentifierTypeStateIssuer
PC3830MedicaidSC

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, 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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1609986769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 AUGUSTA ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054024",
            "telephone_number": "864-271-3930",
            "fax_number": "864-232-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 AUGUSTA STREET",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29611",
            "telephone_number": "864-271-3930",
            "fax_number": "864-232-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SUDHIRKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-271-3930",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "14686",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "19946",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "7609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC3830",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.