Sumter Podiatry Services PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PDO886 Issued in SC

Legal business name

SUMTER PODIATRY SERVICES PA

Practice address

2620 Hardee CV
Sumter, SC 29150-1893

Phone

(803) 469-9255

Fax

(803) 469-9253

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Emanuel Willis, DPMNPI 1255392064

Title

President Podiatrist

Phone

(803) 469-9255

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• Emanuel Willis, DPM

  • Foot Surgery Podiatrist
  • Sumter, SC
  • NPI 1255392064
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1861520157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1485",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291511485",
            "telephone_number": "803-469-9255",
            "fax_number": "803-469-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 HARDEE CV",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501893",
            "telephone_number": "803-469-9255",
            "fax_number": "803-469-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER PODIATRY SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "PRESIDENT PODIATRIST",
        "authorized_official_telephone_number": "803-469-9255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "PDO886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9925",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sumter Pathology Associates
• Sumter Pediatrics, P.a.
• Sumter Pediatrics, P.a.
• Sumter Physical Therapy Clinic, LLC
• Sumter Plastic and Reconstructive Surgery, LLC
• Sumter Pregnancy Center
• Sumter Prosthetics & Orthotics LLC
• Sumter Psychiatry Associates PA
• Sumter Pulmonary Consultants LLC
• Sumter Radiological,PA

• Podiatrist in Sumter, SC
• Providers in Sumter, SC by specialty
• Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.