NPIMap

Organization Active NPI

Georgetown Physician Services LLC

  • Internal Medicine Physician
  • Georgetown, SC
National Provider Identifier
1912186206
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GEORGETOWN PHYSICIAN SERVICES LLC
Practice address
606 Black River Rd
Georgetown, SC 29440-3304
Phone
(843) 527-7100
NPI assigned
Nov 2, 2007
Last updated
Nov 2, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGETOWN HOSPITAL SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Mr. Bruce P Bailey
Title
Ceo
Phone
(843) 527-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

606 Black River Rd
Georgetown, SC 29440-3304

Mailing address

PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 527-7100

National Provider Directory

National Provider Directory
Tax ID family
Georgetown Physician Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1912186206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203",
            "telephone_number": "843-527-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BLACK RIVER RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403304",
            "telephone_number": "843-527-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGETOWN HOSPITAL SYSTEM",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-527-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.