Organization Active NPI

Allergic Disease and Asthma Center

  • Allergy & Immunology Physician
  • Greenville, SC
National Provider Identifier
1841454063
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ALLERGIC DISEASE AND ASTHMA CENTER
Practice address
1202 E Butler Rd
Greenville, SC 29607-5910
Phone
(864) 627-3800
Fax
(864) 672-2653
NPI assigned
Jul 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Dr. Michael W. Reder, MD
Title
Medical Physician
Phone
(864) 269-0386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

1202 E Butler Rd
Greenville, SC 29607-5910

Mailing address

PO Box 27129
Greenville, SC 29616-2129
Phone (864) 627-3800

Other identifiers 1

IdentifierTypeStateIssuer
225018MedicaidSC

National Provider Directory

National Provider Directory

Locations

1202 E Butler Rd
Greenville, SC 29607
Phone (864) 627-3800

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1841454063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27129",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296162129",
            "telephone_number": "864-627-3800",
            "fax_number": "864-672-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075910",
            "telephone_number": "864-627-3800",
            "fax_number": "864-672-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGIC DISEASE AND ASTHMA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "REDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MEDICAL PHYSICIAN",
        "authorized_official_telephone_number": "864-269-0386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225018",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.