Organization Active NPI

Scotland Memorial Hospital

Doing business as Marlboro OB GYN

  • Obstetrics & Gynecology Physician
  • Bennettsville, SC
National Provider Identifier
1891960852
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
36237 Issued in NC
Legal business name
SCOTLAND MEMORIAL HOSPITAL
Doing business as
Marlboro OB GYN
Practice address
1007 Cheraw Highway
Bennettsville, SC 29512
Phone
(243) 479-8357
Fax
(843) 479-8347
NPI assigned
Apr 29, 2008
Last updated
Sep 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Lucien Stonge
Title
Cfo
Phone
(910) 291-7547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 36237 NC Primary

Addresses

Primary practice location

1007 Cheraw Highway
Bennettsville, SC 29512

Mailing address

PO Box 604093
Charlotte, NC 28260-4093
Phone (910) 291-7000

Other identifiers 1

IdentifierTypeStateIssuer
GP4887MedicaidSC

Other names 1

  • MARLBORO OB GYN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000638 SC Part B Supplier - Clinic/Group Practice 0648208504 Receives reassigned benefits from 27 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bennettsville, SC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

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": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1891960852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604093",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604093",
            "telephone_number": "910-291-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 CHERAW HIGHWAY",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "243-479-8357",
            "fax_number": "843-479-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTLAND MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "STONGE",
        "authorized_official_first_name": "LUCIEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-291-7547"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "36237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4887",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARLBORO OB GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARLBORO OB GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bennettsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.