Easley OB GYN Associates PA

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

8415 Issued in SC

Legal business name

EASLEY OB GYN ASSOCIATES PA

Practice address

112 John Street
Suite 201
Easley, SC 29640-1207

Phone

(864) 855-2737

Fax

(864) 855-2221

NPI assigned

Oct 18, 2005

Organization subpart

No

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

Authorized official

Name

John Movius Warren, MD

Title

President

Phone

(864) 855-2737

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720077282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 JOHN ST",
            "address_2": "SUITE 201",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296401472",
            "telephone_number": "864-855-2737",
            "fax_number": "864-855-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 JOHN STREET",
            "address_2": "SUITE 201",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296401207",
            "telephone_number": "864-855-2737",
            "fax_number": "864-855-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASLEY OB GYN ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MOVIUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-855-2737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": "8415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084152",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Easley, SC
• Providers in Easley, SC by specialty
• Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.