Little River Medical Center, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

4406 Issued in SC

Legal business name

LITTLE RIVER MEDICAL CENTER, INC.

Practice address

3001 4TH Ave
Conway, SC 29527-5914

Phone

(843) 488-0272

Fax

(843) 488-0605

NPI assigned

Mar 15, 2010

Organization subpart

Yes

Parent organization

LITTLE RIVER MEDICAL CENTER, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Avangela K Criswell

Title

Bussiness Office Director

Phone

(843) 663-1013

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Little River Medical Center Inc

Locations

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1841514262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 HIGHWAY 90 E STE 5",
            "address_2": "STE #5",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667214",
            "telephone_number": "843-663-1013",
            "fax_number": "843-663-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 4TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295275914",
            "telephone_number": "843-488-0272",
            "fax_number": "843-488-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "CRISWELL",
        "authorized_official_first_name": "AVANGELA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BUSSINESS OFFICE  DIRECTOR",
        "authorized_official_telephone_number": "843-663-1013",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9656",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Little River Medical Center, Inc.
• Johnathan Little
• Michelle L. Little
• Marie P. Livigni, DO

• Dentist in Conway, SC
• Providers in Conway, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.