Piedmont Internal Medicine at Baxter Village LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PIEDMONT INTERNAL MEDICINE AT BAXTER VILLAGE LLC

Practice address

502 Sixth Baxter Crossing
Suite a
Fort Mill, SC 29708

Phone

(803) 802-2424

Fax

(803) 802-3767

NPI assigned

Jul 28, 2006

Last updated

Sep 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. J. Scott Richardson

Title

Vice President

Phone

(469) 893-6960

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baxter Internal Medicine Other name

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1720092505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741344",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841344",
            "telephone_number": "803-802-2424",
            "fax_number": "803-802-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 SIXTH BAXTER CROSSING",
            "address_2": "SUITE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-802-2424",
            "fax_number": "803-802-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT INTERNAL MEDICINE AT BAXTER VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "469-893-6960",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4469",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.