Emmaus Med/Surg Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

30244 Issued in SC

Legal business name

EMMAUS MED/SURG CLINIC

Practice address

602 E Main St
Suite C
Lexington, SC 29072-3729

Phone

(803) 359-0164

Fax

(803) 359-0255

NPI assigned

Sep 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Bert B Oubre, MD

Title

Owner

Phone

(803) 359-0164

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Horace William Bledsoe, MD

  • Adult Medicine Physician
  • Lexington, SC
  • NPI 1972560142
  NPD (past)

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1871827790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E MAIN ST",
            "address_2": "SUITE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723729",
            "telephone_number": "803-359-0164",
            "fax_number": "803-359-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E MAIN ST",
            "address_2": "SUITE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723729",
            "telephone_number": "803-359-0164",
            "fax_number": "803-359-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMAUS MED/SURG CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "OUBRE",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-359-0164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "SC",
            "license": "30244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Huggins Ellis, MSP, CCC-SLP
• Danielle Ellison
• Allyson Elrod-Bloom
• Kelsey Elrod, DNP, FNP-C
• James Brandon Emery, M.D.
• Jan Andre Guevarra Enabore, PHARMD
• Myxael Encarnacion
• Amanda Nicole Enders, MSP, CCC-SLP
• Ebony English, LMT
• John Holbrook English III

• General Practice Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.