NPIMap

Organization Active NPI

Healthstat on-Site Clinic/Milliken Magnolia

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Blacksburg, SC
National Provider Identifier
1942636154
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
HEALTHSTAT ON-SITE CLINIC/MILLIKEN MAGNOLIA
Practice address
157 Milliken Rd.
Blacksburg, SC 29702
Phone
(864) 465-2521
NPI assigned
Sep 19, 2013
Last updated
Sep 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Authorized official

Name
Warren Hutton
Title
Coo
Phone
(704) 529-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X Primary

Addresses

Primary practice location

157 Milliken Rd.
Blacksburg, SC 29702

Mailing address

4651 Charlotte Park Dr
Suite 300
Charlotte, NC 28217-1956

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
42D1065211Healthstat, Inc - on-Site Clinic157 Milliken Road, Blacksburg, SC 29702Certificate of waiverFeb 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthstat Onsite Clinic MVM Columbia238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1942636154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 MILLIKEN RD.",
            "city": "BLACKSBURG",
            "state": "SC",
            "postal_code": "29702",
            "telephone_number": "864-465-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ON-SITE CLINIC/MILLIKEN MAGNOLIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "704-529-6161"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.