Organization Active NPI

Kershaw Urology LLC

  • Urology Physician
  • Camden, SC
National Provider Identifier
1790937829
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
KERSHAW UROLOGY LLC
Practice address
1327 Haile St
Camden, SC 29020-3001
Phone
(202) 498-0909
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Authorized official

Name
Augustine Mireku-Boateng
Title
Ceo and President
Phone
(202) 498-0909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1327 Haile St
Camden, SC 29020-3001

Mailing address

1327 Haile St
Camden, SC 29020-3001

National Provider Directory

National Provider Directory

Locations

1327 Haile St
Camden, SC 29020
Phone (202) 498-0909

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1790937829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 HAILE ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 HAILE ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203001",
            "telephone_number": "202-498-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "MIREKU-BOATENG",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "202-498-0909"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.