NPIMap

Organization Active NPI

Network Geriatric Services, PA

  • Geriatric Medicine (Family Medicine) Physician
  • Spartanburg, SC
National Provider Identifier
1922045103
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
12758 Issued in SC
Legal business name
NETWORK GERIATRIC SERVICES, PA
Practice address
103 S Pine St
Spartanburg, SC 29302-1972
Phone
(864) 327-1510
Fax
(864) 327-1662
NPI assigned
May 31, 2006
Last updated
Dec 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Authorized official

Name
Dr. Roy Bradford Whitney, M.D.
Title
Ceo
Phone
(864) 327-1510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 12758 SC Primary

Addresses

Primary practice location

103 S Pine St
Spartanburg, SC 29302-1972

Mailing address

103 S Pine St
Spartanburg, SC 29302-1972
Phone (864) 327-1510

Other identifiers 1

IdentifierTypeStateIssuer
GP4420MedicaidSC

National Provider Directory

National Provider Directory

Locations

103 S Pine St
Spartanburg, SC 29302
Phone (864) 327-1510

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1922045103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021972",
            "telephone_number": "864-327-1510",
            "fax_number": "864-327-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021972",
            "telephone_number": "864-327-1510",
            "fax_number": "864-327-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NETWORK GERIATRIC SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-327-1510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "12758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4420",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

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