NPIMap

Organization Active NPI

Centa Medical Group PA

  • Otolaryngology Physician
  • Lexington, SC
National Provider Identifier
1881626133
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CENTA MEDICAL GROUP PA
Practice address
157 Corley Mill Rd
Lexington, SC 29072
Phone
(803) 256-2483
Fax
(803) 799-4624
NPI assigned
Jul 7, 2006
Last updated
Jul 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Jane M. Albright
Title
Credentialing
Phone
(803) 520-5448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

157 Corley Mill Rd
Lexington, SC 29072

Mailing address

157 Corley Mill Rd
Lexington, SC 29072
Phone (803) 256-2483

Other identifiers 3

IdentifierTypeStateIssuer
DC6996OtherRAILROAD MEDICARE
PA1382MedicaidSC
GP4644OtherSCMEDICAID AUDIOLOGY GRP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000075 SC Part B Supplier - Clinic/Group Practice 9335108778 Receives reassigned benefits from 12 practitioners
Practice locations: Lexington, SC

National Provider Directory

National Provider Directory

Locations

9 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 256-2483

157 Corley Mill Rd
Lexington, SC 29072
Phone (803) 256-2483

2720 Sunset Blvd
Ste 4100
West Columbia, SC 29169
Phone (803) 796-5433

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1881626133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-256-2483",
            "fax_number": "803-799-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-256-2483",
            "fax_number": "803-799-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTA MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "ALBRIGHT",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "803-520-5448"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6996",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA1382",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AUDIOLOGY GRP NUMBER",
            "identifier": "GP4644",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.