NPIMap

Organization Active NPI

Doctors Care SC, PA

Doing business as Doctors Care East Blackstock

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1801135785
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS CARE SC, PA
Doing business as
Doctors Care East Blackstock
Practice address
218 E Blackstock Rd
Spartanburg, SC 29301-2607
Phone
(864) 576-8646
Fax
(864) 576-8932
NPI assigned
Feb 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Dr. Shelley Janssen, MD
Title
Credentialing Supervisor
Phone
(803) 782-4278

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

218 E Blackstock Rd
Spartanburg, SC 29301-2607

Mailing address

1818 Henderson St
Columbia, SC 29201-2619
Phone (803) 758-2600

Other identifiers 1

IdentifierTypeStateIssuer
GP0110MedicaidSC

Other names 1

  • Doctors Care East Blackstock Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doctors Care of South63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1801135785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-758-2600",
            "fax_number": "803-253-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E BLACKSTOCK RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293012607",
            "telephone_number": "864-576-8646",
            "fax_number": "864-576-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS CARE SC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "JANSSEN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "803-782-4278",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0110",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Care East Blackstock",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Doctors Care East Blackstock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.