Jerome B Degen, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

07054 Issued in SC

Practice address

1175 Cook Rd
Suite 305
Orangeburg, SC 29118-8201

Phone

(803) 536-9390

Fax

(803) 533-0911

NPI assigned

Dec 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1669654448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 305",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-536-9390",
            "fax_number": "803-533-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD",
            "address_2": "SUITE 305",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-536-9390",
            "fax_number": "803-533-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEN",
        "first_name": "JEROME",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "07054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070540",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Obstetrics & Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.