Active NPI
Honored to Serve, LLC
- Podiatrist
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- POD001155
- Legal business name
- HONORED TO SERVE, LLC
- Practice address
- 4100 N Main St Ste 204
Columbia, SC 29203-5800 - Phone
- (803) 401-5356
- NPI assigned
- Sep 5, 2017
- Last updated
- Jan 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle P Glover, DPM
- Title
- Owner
- Phone
- (803) 401-5356
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | POD001155 | SC | Primary |
Addresses
Primary practice location
4100 N Main St Ste 204
Columbia, SC 29203-5800
Mailing address
4100 N Main St Ste 204
Columbia, SC 29203-5800
Phone (803) 401-5356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PG9981 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4100 N Main St
Ste 204
Columbia, SC 29203
Phone (803) 401-5356
159 Sedgewood Dr
Rock Hill, SC 29732
Phone (803) 329-6565
1527 Urbana Rd
Summerton, SC 29148
Phone (803) 485-2317
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Foot & Ankle Surgery Podiatrist
- Columbia, SC
- NPI 1154627008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675036800000",
"number": "1871011387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 N MAIN ST STE 204",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292035800",
"telephone_number": "803-401-5356",
"fax_number": "803-497-3844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 N MAIN ST STE 204",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292035800",
"telephone_number": "803-401-5356"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HONORED TO SERVE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-05",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A",
"authorized_official_last_name": "GLOVER",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "803-401-5356",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "SC",
"license": "POD001155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PG9981",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.