Southern Grace Pain & Regenerative Medicine

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE

Practice address

3520 Park Avenue Blvd., Suite 105
Mount Pleasant, SC 29466

Phone

(843) 754-4231

NPI assigned

Mar 13, 2020

Last updated

Mar 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Blane Blane Richardson, MD

Title

Provider/Owner

Phone

(843) 754-4231

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• William B Richardson, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Charleston, SC
  • NPI 1215000468
  NPD

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1942836754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 BECKENHAM DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669009",
            "telephone_number": "843-754-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 PARK AVENUE BLVD., SUITE 105",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29466",
            "telephone_number": "843-754-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "WILLIAM BLANE",
        "authorized_official_middle_name": "BLANE",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "843-754-4231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Pain Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.