South Carolina Podiatric Physicians and Surgeons Group, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

564 Issued in SC

Legal business name

SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC

Practice address

1575 E Main St
Duncan, SC 29334-9218

Phone

(864) 487-3338

Fax

(864) 487-4102

NPI assigned

Feb 27, 2014

Organization subpart

No

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

Authorized official

Name

Brandon Percival, DPM

Title

President

Phone

(803) 285-1411

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399507200000",
    "number": "1669897690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "803-285-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 E MAIN ST",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349218",
            "telephone_number": "864-487-3338",
            "fax_number": "864-487-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-05-08",
        "status": "A",
        "authorized_official_last_name": "PERCIVAL",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-285-1411",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shri Dhanvantri PA
• Brooke Elizabeth Simpson
• James Kirkland Smith, MSW
• Joanna Smith, FNP-BC
• Tracy Y Smith
• Southeastern Children'S Home
• Southeastern Children'S Home, Inc.
• Southeastern Children'S Home, Inc.
• Alexis Sparks
• Spartanburg County School District No. 5

• Foot & Ankle Surgery Podiatrist in Duncan, SC
• Providers in Duncan, 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 May 8, 2014; 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.