Active NPI
Terry L. Dodge, M.D.
- Anesthesiology Physician
- Chester, SC
National Provider Identifier
1639168339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 6992
- Practice address
- 1 Medical Park Dr
Chester, SC 29706-9769 - Phone
- (803) 581-3151
- Fax
- (803) 385-3183
- NPI assigned
- Oct 17, 2005
- Last updated
- Jul 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 6992 | SC | Primary |
Addresses
Primary practice location
1 Medical Park Dr
Chester, SC 29706-9769
Mailing address
1 Medical Park Dr
Chester, SC 29706-9769
Phone (803) 581-3151
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 069927 | Medicaid | SC | |
| A9373 | Other | MEDCOST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6992 | SC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Community Care Inc | Past | Accepting new patients | |
| Anesthesia Associates of Rock Hill, P.a. | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Chester, SC
- NPI 1992968036
-
- Anesthesiology Physician
- Rock Hill, SC
- NPI 1811977200
-
dba Hospice & Community Care
- Community Based Hospice Care Agency
- Rock Hill, SC
- NPI 1598721771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1639168339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK DR",
"city": "CHESTER",
"state": "SC",
"postal_code": "297069769",
"telephone_number": "803-581-3151",
"fax_number": "803-385-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK DR",
"city": "CHESTER",
"state": "SC",
"postal_code": "297069769",
"telephone_number": "803-581-3151",
"fax_number": "803-385-3183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "TERRY",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "6992",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "069927",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "A9373",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Chester, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.