Organization Active NPI

Windham Gynecology, LLC

  • Gynecology Physician
  • Florence, SC
National Provider Identifier
1881623601
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
149324 Issued in SC
Legal business name
WINDHAM GYNECOLOGY, LLC
Practice address
509 S Coit St
Florence, SC 29501-5220
Phone
(843) 676-1435
Fax
(843) 676-1437
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Nancy Windham, M.D.NPI 1770584799
Title
Physician
Phone
(843) 676-1435

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 149324 SC Primary

Addresses

Primary practice location

509 S Coit St
Florence, SC 29501-5220

Mailing address

509 S Coit St
Florence, SC 29501-5220
Phone (843) 676-1435

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120313000962 SC Part B Supplier - Clinic/Group Practice 4981863719 Receives reassigned benefits from 1 practitioner
Practice locations: Florence, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0958976Windham Gynecology LLC509 S Coit Street, Florence, SC 29501Provider-performed microscopyJan 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881623601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S COIT ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015220",
            "telephone_number": "843-676-1435",
            "fax_number": "843-676-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 S COIT ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015220",
            "telephone_number": "843-676-1435",
            "fax_number": "843-676-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINDHAM",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-676-1435",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": "149324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.