NPIMap

Organization Active NPI

Upstate Podiatry Group, PA

  • Durable Medical Equipment & Medical Supplies
  • Clinton, SC
National Provider Identifier
1619479342
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UPSTATE PODIATRY GROUP, PA
Practice address
1012 Medical Ridge Rd
Clinton, SC 29325-4542
Phone
(864) 833-9274
NPI assigned
Mar 8, 2018
Organization subpart
Yes
Parent organization
UPSTATE PODIATRY GROUP, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Stephanie Thomas
Title
Practice Administrator
Phone
(864) 399-9070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1012 Medical Ridge Rd
Clinton, SC 29325-4542

Mailing address

801 SE Main St
Simpsonville, SC 29681-7150
Phone (864) 399-9070

National Provider Directory

National Provider Directory
Part of
Upstate Podiatry Group PA

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1619479342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SE MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817150",
            "telephone_number": "864-399-9070",
            "fax_number": "864-399-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 MEDICAL RIDGE RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293254542",
            "telephone_number": "864-833-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PODIATRY GROUP, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPSTATE PODIATRY GROUP, PA",
        "enumeration_date": "2018-03-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-399-9070"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.