Pendleton Family Practice, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PENDLETON FAMILY PRACTICE, LLC

Practice address

101 Shirley St
Pendleton, SC 29670-1824

Phone

(864) 646-7522

Fax

(864) 646-3377

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Stacy Lee Smith, M.D.NPI 1891718706

Title

Owner/Physician

Phone

(864) 646-7522

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Stacy Lee Smith, M.D.

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1891718706
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1790705259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296700547",
            "telephone_number": "864-646-7522",
            "fax_number": "864-646-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SHIRLEY ST",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701824",
            "telephone_number": "864-646-7522",
            "fax_number": "864-646-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLETON FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "864-646-7522",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3375",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle A Miller, FNP-BC
• Zoe Ogrodnik, BCABA
• Amanda L Ozolins, ATC
• Alison N Peeples, APRN
• Pendleton Area Rescue Squad
• Pendleton Medical Clinic
• Pendleton Neighborhood Dental, LLC
• Alekhya Rao, D.M.D.
• Vasantha Rao, DMD DENTIST
• Rathompson in

• Family Medicine Physician in Pendleton, SC
• Providers in Pendleton, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.