NPIMap

Organization Active NPI

Ies South Carolina LLC

  • Emergency Medicine Physician
  • Hartsville, SC
National Provider Identifier
1821779695
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
IES SOUTH CAROLINA LLC
Practice address
1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone
(843) 339-2100
NPI assigned
Jul 26, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Nestor Zenarosa, MDNPI 1629096375
Title
Owner
Phone
(469) 420-5527

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710

Mailing address

PO Box 3320
Indianapolis, IN 46206-3320
Phone (469) 420-5527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230914000885 SC Part B Supplier - Clinic/Group Practice 1355705070 Receives reassigned benefits from 42 practitioners
Practice locations: Hartsville, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1821779695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063320",
            "telephone_number": "469-420-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IES SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "ZENAROSA",
        "authorized_official_first_name": "NESTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-420-5527",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.