Pediatric Innovations

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

PEDIATRIC INNOVATIONS

Practice address

1401 Saint Andrews Rd
Suite 150
Columbia, SC 29210-5930

Phone

(803) 551-1113

Fax

(803) 551-0905

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Marc Huntley Suddarth

Title

President

Phone

(803) 551-1113

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801878376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SAINT ANDREWS RD",
            "address_2": "SUITE 150",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105930",
            "telephone_number": "803-551-1113",
            "fax_number": "803-551-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SAINT ANDREWS RD",
            "address_2": "SUITE 150",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105930",
            "telephone_number": "803-551-1113",
            "fax_number": "803-551-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUDDARTH",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "HUNTLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-551-1113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1853",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Columbia, SC
• Providers in Columbia, SC by specialty
• Customized Equipment (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.