Individual provider Active NPI

Ugochi Cantave, MD

  • Pediatrics Physician
  • Port Royal, SC
National Provider Identifier
1720219256
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
TL32111 Issued in SC
Practice address
1875 N Paris Ave
Port Royal, SC 29935-2029
Phone
(843) 522-3870
Fax
(843) 522-0691
NPI assigned
Jul 31, 2009
Last updated
Jul 31, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X TL32111 SC Primary

Addresses

Primary practice location

1875 N Paris Ave
Port Royal, SC 29935-2029

Mailing address

1875 N Paris Ave
Port Royal, SC 29935-2029
Phone (843) 522-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120330000647 SC Practitioner - Pediatric Medicine 5092975813 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL32111SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. Pediatrics CurrentSince Jan 9, 2012 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Jan 9, 2012 Accepting new patients
Southern Medical Management, LLC Pediatrics Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Lexington Health Inc Past Accepting new patients
Sweetgrass Pediatrics Pediatrics Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Pediatrics of Newberry, LLC Pediatrics Past Accepting new patients

Locations

2117 Gervais St
Columbia, SC 29204
Phone (803) 744-0540

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

4605 Monticello Rd
Ste 1
Columbia, SC 29203
Phone (803) 252-7001

Interoperability endpoints

  • Direct secure messaging: ugochi.cantave.1@10781.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1720219256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 N PARIS AVE",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352029",
            "telephone_number": "843-522-3870",
            "fax_number": "843-522-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 N PARIS AVE",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352029",
            "telephone_number": "843-522-3870",
            "fax_number": "843-522-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTAVE",
        "first_name": "UGOCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "TL32111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Royal, SC

Sources for this page

Verify at the official NPI Registry.