Active NPI
Diane M Price
- Durable Medical Equipment & Medical Supplies
- Jefferson, SC
National Provider Identifier
1669630406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 013094297
- Practice address
- 109 Sandhills VFD Rd
Jefferson, SC 29718-8683 - Phone
- (843) 658-3508
- Fax
- (843) 658-6390
- NPI assigned
- May 29, 2008
- Last updated
- May 29, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 013094297 | SC | Primary |
Addresses
Primary practice location
109 Sandhills VFD Rd
Jefferson, SC 29718-8683
Mailing address
109 Sandhills VFD Rd
Jefferson, SC 29718-8683
Phone (843) 658-3508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE2676 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013094297 | SC | MD | Durable Medical Equipment & Medical Supplies |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1669630406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 SANDHILLS VFD RD",
"city": "JEFFERSON",
"state": "SC",
"postal_code": "297188683",
"telephone_number": "843-658-3508",
"fax_number": "843-658-6390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 SANDHILLS VFD RD",
"city": "JEFFERSON",
"state": "SC",
"postal_code": "297188683",
"telephone_number": "843-658-3508",
"fax_number": "843-658-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICE",
"first_name": "DIANE",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "SC",
"license": "013094297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DE2676",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.