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

Last updated

Sep 24, 2009By the provider in NPPES

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, MDNPI 1528201480

Title

Owner

Phone

(803) 359-0164

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Bert B Oubre, M.D.

  • Family Medicine Physician
  • Lexington, SC
  • NPI 1528201480
  Authorized official Same address or phone
• 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.