Internal Medicine Specialist Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE SPECIALIST GROUP LLC

Practice address

225 S Herlong Ave
Suite 230
Rock Hill, SC 29732-2168

Phone

(803) 366-3900

Fax

(803) 366-1213

NPI assigned

Jan 3, 2020

Organization subpart

No

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

Authorized official

Name

Deovyaas Sharma, MDNPI 1790891547

Title

Owner

Phone

(803) 416-3710

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deovyaas S Sharma, M.D.

  • Internal Medicine Physician
  • Rock Hill, SC
  • NPI 1790891547
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1952940223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S HERLONG AVE",
            "address_2": "SUITE 230",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322168",
            "telephone_number": "803-366-3900",
            "fax_number": "803-366-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S HERLONG AVE",
            "address_2": "SUITE 230",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322168",
            "telephone_number": "803-366-3900",
            "fax_number": "803-366-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE SPECIALIST GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "DEOVYAAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-416-3710",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T79073",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "imsgcarolina.com",
            "affiliation": "N",
            "address_1": "225 S Herlong Ave",
            "address_2": "Suite 230",
            "city": "Rock Hill",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297322168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.