Sc278 Medical Group PA

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

15103 Issued in SC

Legal business name

SC278 MEDICAL GROUP PA

Practice address

1714 Tickton Hall Rd
Ridgeland, SC 29936-7719

Phone

(843) 726-2194

Fax

(843) 726-9423

NPI assigned

Dec 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Scott Douglas Condie, MD

Title

President

Phone

(843) 757-5966

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Josieann Mauro Eccles, PA

  • Physician Assistant
  • Ridgeland, SC
  • NPI 1821024662
  NPD (past)

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

{
    "created_epoch": "1165708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821158122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3066",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299103066",
            "telephone_number": "843-757-5966",
            "fax_number": "843-757-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 TICKTON HALL RD",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299367719",
            "telephone_number": "843-726-2194",
            "fax_number": "843-726-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SC278 MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONDIE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-757-5966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "15103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Maria Rodriguez-Maldonado, M.D.
• Stephany Rodriguez
• Christina Laura Salese
• SC Department of Juvenile Justice
• SC Opco LLC (Ridgeland Nursing and Rehab Center)
• Kristin Scott-Groves, MSW
• Daryl Seldes
• Shoreline Medical Transport
• Shoreline Medical Transport LLC
• Mark Alan Siar

• Geriatric Medicine (Family Medicine) Physician in Ridgeland, SC
• Providers in Ridgeland, SC by specialty
• Geriatric Medicine (Family Medicine) Physician 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.