NPIMap

Organization Active NPI

Carolina Center for Diabetes Education

  • Endocrinology, Diabetes & Metabolism Physician
  • Spartanburg, SC
National Provider Identifier
1689830622
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CAROLINA CENTER FOR DIABETES EDUCATION
Practice address
853 N Church St Ste 720C
Spartanburg, SC 29303-3098
Phone
(864) 560-4304
NPI assigned
Jul 30, 2008
Last updated
Jul 30, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL MEDICAL CTRAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Janice Fowler
Title
Credentialing
Phone
(864) 560-4475

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

853 N Church St Ste 720C
Spartanburg, SC 29303-3098

Mailing address

PO Box 2168
Spartanburg, SC 29304-2168
Phone (864) 560-6419

Other identifiers 1

IdentifierTypeStateIssuer
DEP019MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Harriett Goodrich PA136 organizations share this tax ID, including this one
Part of
Harriett Goodrich PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1689830622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293042168",
            "telephone_number": "864-560-6419",
            "fax_number": "864-560-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST STE 720C",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033098",
            "telephone_number": "864-560-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CENTER FOR DIABETES EDUCATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL MEDICAL CTR",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "864-560-4475"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DEP019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.