Organization Active NPI

Carolina Pediatrics at Rock Hill LLC

  • Pediatrics Physician
  • Rock Hill, SC
National Provider Identifier
1780270744
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CAROLINA PEDIATRICS AT ROCK HILL LLC
Practice address
225 Herlong Ave S Ste 201
Rock Hill, SC 29732-2168
Phone
(803) 327-9999
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Carlos G Paxtor, MD
Title
Pediatrician/Provider
Phone
(803) 327-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

225 Herlong Ave S Ste 201
Rock Hill, SC 29732-2168

Mailing address

225 Herlong Ave S Ste 201
Rock Hill, SC 29732-2168
Phone (803) 327-9999

Other identifiers 1

IdentifierTypeStateIssuer
PG0184MedicaidSC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2227051Carolina Pediatrics at Rock Hill225 S Herlong Ave Ste 201, Rock Hill, SC 29732Certificate of waiverJun 7, 2027

National Provider Directory

National Provider Directory

Locations

1646 Highway 160 W
Ste 8120
Fort Mill, SC 29708

225 Herlong Ave S
Ste 201
Rock Hill, SC 29732
Phone (803) 329-6030

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22956/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1780270744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 HERLONG AVE S STE 201",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322168",
            "telephone_number": "803-327-9999",
            "fax_number": "803-327-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HERLONG AVE S STE 201",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322168",
            "telephone_number": "803-327-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PEDIATRICS AT ROCK HILL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "PAXTOR",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PEDIATRICIAN/PROVIDER",
        "authorized_official_telephone_number": "803-327-9999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG0184",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.