Daniel Ab Methuselah DPM LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

517 Issued in SC

Legal business name

DANIEL AB METHUSELAH DPM LLC

Doing business as

Carolina Podiatric Medical Associates

Practice address

7182 Woodrow St Ste 105
Irmo, SC 29063-2832

Phone

(803) 781-3500

Fax

(803) 781-2924

NPI assigned

Feb 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Ab Methuselah, M.D.NPI 1093760241

Title

Owner/ Physician

Phone

(803) 781-3500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Carolina Podiatric Medical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Ab Methuselah, DPM

  • Podiatrist
  • Irmo, SC
  • NPI 1093760241
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1659540771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 105",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-781-3500",
            "fax_number": "803-781-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 105",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-781-3500",
            "fax_number": "803-781-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL AB METHUSELAH DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "METHUSELAH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "AB",
        "authorized_official_title_or_position": "OWNER/ PHYSICIAN",
        "authorized_official_telephone_number": "803-781-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "517",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480027811",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Podiatric Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Podiatric Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Irmo, SC
• Providers in Irmo, SC by specialty
• Foot & Ankle Surgery Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.