NPIMap

Organization Active NPI

The Regional Medical Center

  • Surgery Physician
  • Orangeburg, SC
National Provider Identifier
1730132762
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
THE REGIONAL MEDICAL CENTER
Practice address
870 Holly St
Orangeburg, SC 29115-4831
Phone
(803) 395-2060
Fax
(803) 395-0998
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lisa Goodlett
Title
Cfo
Phone
(803) 395-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

870 Holly St
Orangeburg, SC 29115-4831

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-2060

Other identifiers 1

IdentifierTypeStateIssuer
GP4407MedicaidSC

Other names 1

  • DBA:Dr. Stewart Funderburk Other name

National Provider Directory

National Provider Directory
Tax ID family
Allen Migliaccio Crna14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730132762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-2060",
            "fax_number": "803-536-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 HOLLY ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154831",
            "telephone_number": "803-395-2060",
            "fax_number": "803-395-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODLETT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "803-395-2200"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4407",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA:Dr. Stewart Funderburk",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orangeburg, SC

Sources for this page

  • 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.