Chesterfield-Marlboro, LP

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CHESTERFIELD-MARLBORO, LP

Practice address

711 Chesterfield Hwy
Cheraw, SC 29520-7002

Phone

(843) 320-3304

Fax

(843) 320-3480

NPI assigned

May 5, 2006

Last updated

Oct 28, 2011By 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

Debbie Brewer

Title

Director of Provider Enrollment

Phone

(866) 398-7108

Specialties & licenses 4

Addresses

Other identifiers 4

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1730137092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207002",
            "telephone_number": "843-320-3304",
            "fax_number": "843-320-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207002",
            "telephone_number": "843-320-3304",
            "fax_number": "843-320-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERFIELD-MARLBORO, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "866-398-7108"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400621",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890769B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012AV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG3996",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chesterfield Marlboro LP (Chesterfield General Hospital)
• Chesterfield Marlboro Urology
• Chesterfield Marlboro, LP (Chesterfield General Hospital)
• Chesterfield Visiting Nurses Service Inc (SunCrest Home Health)
• Chesterfield-Marlboro Urology, P.C.
• Qasim Shehzad Choudhry, DO
• Community Spoon Home Meals
• Condon Med Services of Cheraw
• Foy Douglas Connell, M.D.
• Holly Byrd Copeland, FNP

• Emergency Medicine Physician in Cheraw, SC
• Providers in Cheraw, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.