NPIMap

Organization Active NPI

Georgetown Gastroenterology, LLC

Doing business as Waccamaw Gastroenterology, PC

  • Gastroenterology Physician
  • Georgetown, SC
National Provider Identifier
1619283306
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GEORGETOWN GASTROENTEROLOGY, LLC
Doing business as
Waccamaw Gastroenterology, PC
Practice address
1011 N Fraser St
Georgetown, SC 29440-2848
Phone
(843) 527-3428
Fax
(843) 546-8216
NPI assigned
Aug 19, 2010
Last updated
Jun 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Authorized official

Name
Kenton Hungerpiller
Title
Business Manager
Phone
(843) 652-8221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

1011 N Fraser St
Georgetown, SC 29440-2848

Mailing address

PO Box 1209
Murrells Inlet, SC 29576-1209
Phone (843) 652-8220

Other identifiers 1

IdentifierTypeStateIssuer
GP1579MedicaidSC

Other names 1

  • Waccamaw Gastroenterology, PC Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1619283306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295761209",
            "telephone_number": "843-652-8220",
            "fax_number": "843-527-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402848",
            "telephone_number": "843-527-3428",
            "fax_number": "843-546-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "HUNGERPILLER",
        "authorized_official_first_name": "KENTON",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "843-652-8221"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1579",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waccamaw Gastroenterology, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.