NPIMap

Organization Active NPI

Parkwood Pediatric Group PA

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1659521201
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PARKWOOD PEDIATRIC GROUP PA
Practice address
1243 Savannah Hwy
Charleston, SC 29407-7817
Phone
(843) 556-8110
Fax
(843) 556-8112
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Authorized official

Name
Mr. Charles W Kisabeth, M.D.
Title
Physician
Phone
(843) 266-7636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1243 Savannah Hwy
Charleston, SC 29407-7817

Mailing address

1243 Savannah Hwy
Charleston, SC 29407-7817
Phone (843) 556-8110

National Provider Directory

National Provider Directory

Locations

1243 Savannah Hwy
Charleston, SC 29407
Phone (843) 556-8110

Practitioners & affiliated clinicians

Practitioners 5

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": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1659521201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077817",
            "telephone_number": "843-556-8110",
            "fax_number": "843-556-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077817",
            "telephone_number": "843-556-8110",
            "fax_number": "843-556-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWOOD PEDIATRIC GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "KISABETH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-266-7636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.