Omscor LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

OMSCOR LLC

Practice address

218 Wall St
Powdersville, SC 29673-6754

Phone

(864) 420-2738

NPI assigned

Dec 1, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Brett Shigley, DMD, MS

Title

President

Phone

(864) 420-2738

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1679178206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 WOODRUFF RD STE 106-180",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074172",
            "telephone_number": "864-420-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 WALL ST",
            "city": "POWDERSVILLE",
            "state": "SC",
            "postal_code": "296736754",
            "telephone_number": "864-420-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMSCOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "SHIGLEY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-420-2738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Powdersville, SC
• Providers in Powdersville, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.