Teen Health Center

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

77686 Issued in SC

Legal business name

TEEN HEALTH CENTER

Practice address

725 Cherry Rd
Suite 104
Rock Hill, SC 29732-3150

Phone

(803) 366-9119

Fax

(803) 366-9389

NPI assigned

Dec 22, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Janice E Richards

Title

Office Manager

Phone

(803) 366-9119

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770560526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CHERRY RD",
            "address_2": "SUITE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323150",
            "telephone_number": "803-366-9119",
            "fax_number": "803-366-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CHERRY RD",
            "address_2": "SUITE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323150",
            "telephone_number": "803-366-9119",
            "fax_number": "803-366-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEEN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-366-9119",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "77686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3274",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Nurse Practitioner 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.