NPIMap

Organization Active NPI

Sumter Gastroenterology

  • Gastroenterology Physician
  • Sumter, SC
National Provider Identifier
1699071746
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SUMTER GASTROENTEROLOGY
Practice address
641 W Wesmark Blvd
Sumter, SC 29150-1900
Phone
(803) 905-6944
Fax
(803) 469-3944
NPI assigned
Feb 8, 2011
Last updated
Dec 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Meg Kwiecinski
Title
Business Office Manager
Phone
(803) 905-6944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

641 W Wesmark Blvd
Sumter, SC 29150-1900

Mailing address

641 W Wesmark Blvd
Sumter, SC 29150-1900
Phone (803) 905-6944

Other identifiers 1

IdentifierTypeStateIssuer
GP5689MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Sumtergastro@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110510000588 SC Part B Supplier - Clinic/Group Practice 2264618164 Receives reassigned benefits from 7 practitioners
Practice locations: Sumter, SC

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

641 W Wesmark Blvd
Sumter, SC 29150
Phone (803) 778-1941

Interoperability endpoints

  • Direct secure messaging: sumtergastro@directaddress.net

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1699071746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-905-6944",
            "fax_number": "803-469-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-905-6944",
            "fax_number": "803-469-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2022-12-29",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "KWIECINSKI",
        "authorized_official_first_name": "MEG",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "803-905-6944"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5689",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Sumtergastro@directaddress.net",
            "affiliation": "N",
            "address_1": "641 W Wesmark Blvd",
            "city": "Sumter",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291501900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.