General Medicine Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5707 Issued in SC

Legal business name

GENERAL MEDICINE CLINIC

Practice address

304 Market Street
Bennettsville, SC 29512

Phone

(843) 479-3837

NPI assigned

Apr 27, 2007

Organization subpart

No

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

Authorized official

Name

Miss Mary Gore, BA

Title

Office Manager

Phone

(843) 479-3837

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1710107057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MARKET STREET",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "843-479-3837",
            "fax_number": "843-479-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MARKET STREET",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "843-479-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-479-3837",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "5707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA0098",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bennettsville, SC
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• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.