Active NPI
Charles G Sasser, MD
- Internal Medicine Physician
- Conway, SC
National Provider Identifier
1669555736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5402
- Practice address
- 8002 Myrtle Trace Dr
Conway, SC 29526-8945 - Phone
- (843) 347-7227
- Fax
- (843) 347-7232
- NPI assigned
- Oct 23, 2006
- Last updated
- Jan 28, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5402 | SC | Primary |
Addresses
Primary practice location
8002 Myrtle Trace Dr
Conway, SC 29526-8945
Mailing address
PO Box 6407
Florence, SC 29502-6407
Phone (843) 669-5162
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA7901 | Medicaid | SC | |
| 054023 | Medicaid | SC |
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 |
|---|---|---|---|
| 5402 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conway Internists, P.a. | Internal Medicine | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Conway Hospital Long Term Care Services, Inc | Past | Accepting new patients |
Locations
8002 Myrtle Trace Dr
Conway, SC 29526
Phone (843) 347-7227
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.
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- Internal Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1669555736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6407",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295026407",
"telephone_number": "843-669-5162",
"fax_number": "843-667-4573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8002 MYRTLE TRACE DR",
"city": "CONWAY",
"state": "SC",
"postal_code": "295268945",
"telephone_number": "843-347-7227",
"fax_number": "843-347-7232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASSER",
"first_name": "CHARLES",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "5402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA7901",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "054023",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.