Organization Active NPI

Honored to Serve, LLC

  • Podiatrist
  • Columbia, SC
National Provider Identifier
1871011387
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001155 Issued in SC
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, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Michelle P Glover, DPMNPI 1154627008
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)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
PG9981MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171106000349 SC Part B Supplier - Clinic/Group Practice 0547526709 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.