Organization Active NPI

Trent Cannon & Riddick Ackerman III

  • Obstetrics & Gynecology Physician
  • Walterboro, SC
National Provider Identifier
1679510416
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TRENT CANNON & RIDDICK ACKERMAN III
Practice address
400 Constance St
Walterboro, SC 29488-2710
Phone
(843) 549-9568
Fax
(843) 549-1530
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Christy B. Martin, N.P.
Title
Office Manager
Phone
(843) 549-9568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

400 Constance St
Walterboro, SC 29488-2710

Mailing address

400 Constance St
Walterboro, SC 29488-2710
Phone (843) 549-9568

Other identifiers 1

IdentifierTypeStateIssuer
GP0529MedicaidSC

Other names 1

  • Walterboro Ob/Gyn Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1679510416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONSTANCE ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882710",
            "telephone_number": "843-549-9568",
            "fax_number": "843-549-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONSTANCE ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882710",
            "telephone_number": "843-549-9568",
            "fax_number": "843-549-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENT CANNON & RIDDICK ACKERMAN III",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-549-9568",
        "authorized_official_credential": "N.P."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walterboro Ob/Gyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.