NPIMap

Organization Active NPI

Providence Orthopedic Group, LLC

Doing business as Moore Center for Orthopedics

  • Orthopaedic Surgery Physician
  • Lexington, SC
National Provider Identifier
1831513324
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PROVIDENCE ORTHOPEDIC GROUP, LLC
Doing business as
Moore Center for Orthopedics
Practice address
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone
(803) 227-8000
NPI assigned
Feb 5, 2014
Last updated
Feb 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Mr. Matt Frick
Title
Avd, Outpatient Services
Phone
(803) 227-8104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

104 Saluda Pointe Dr
Lexington, SC 29072-7295

Mailing address

7936 Broad River Rd
Irmo, SC 29063-2355
Phone (803) 227-8000

Other names 1

  • Moore Center for Orthopedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Moore Center for Orthopedics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1831513324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7936 BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632355",
            "telephone_number": "803-227-8000",
            "fax_number": "803-227-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SALUDA POINTE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727295",
            "telephone_number": "803-227-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ORTHOPEDIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "FRICK",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "AVD, OUTPATIENT SERVICES",
        "authorized_official_telephone_number": "803-227-8104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Center for Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.