NPIMap

Organization Active NPI

Rock Hill Surgical Associates PA

  • Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1639173388
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
250665365 Issued in SC
Legal business name
ROCK HILL SURGICAL ASSOCIATES PA
Practice address
1721 Ebenezer Rd
Suite 175
Rock Hill, SC 29732-4103
Phone
(803) 324-5256
Fax
(803) 328-0440
NPI assigned
Jun 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Pat Fedele
Title
Practice Administrator
Phone
(803) 324-5256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 250665365 SC Primary

Addresses

Primary practice location

1721 Ebenezer Rd
Suite 175
Rock Hill, SC 29732-4103

Mailing address

PO Box 36070
Rock Hill, SC 29732-0500
Phone (803) 324-5256

Other identifiers 1

IdentifierTypeStateIssuer
PA3601MedicaidSC

National Provider Directory

National Provider Directory

Locations

1721 Ebenezer Rd
#7
Rock Hill, SC 29732
Phone (803) 324-5257

Practitioners & affiliated clinicians

Practitioners 6

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": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1639173388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36070",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297320500",
            "telephone_number": "803-324-5256",
            "fax_number": "803-328-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD",
            "address_2": "SUITE 175",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297324103",
            "telephone_number": "803-324-5256",
            "fax_number": "803-328-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK HILL SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "FEDELE",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-324-5256"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "SC",
            "license": "250665365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA3601",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

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