Audrey Tise Kazer

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RC-1399 Issued in SC

Practice address

570 Center Rd
Chester, SC 29706-6880

Phone

(336) 749-1015

NPI assigned

Dec 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1790290872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1597",
            "city": "KING",
            "state": "NC",
            "postal_code": "270211597",
            "telephone_number": "336-749-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 CENTER RD",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297066880",
            "telephone_number": "336-749-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZER",
        "first_name": "AUDREY",
        "middle_name": "TISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "RC-1399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC-1399",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Chester, SC
• Providers in Chester, SC by specialty
• Assisted Living Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.