Upstate Podiatry Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

UPSTATE PODIATRY GROUP

Practice address

1010 W Main St
Laurens, SC 29360-2608

Phone

(864) 399-9070

NPI assigned

Jun 16, 2021

Last updated

Jun 16, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

UPSTATE PODIATRY GROUP, PAAs reported in NPPES

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

Authorized official

Name

Stephanie Riddle

Title

Cfo

Phone

(864) 399-9070

Specialties & licenses 2

Addresses

Electronic endpoints 1

Part of

Upstate Podiatry Group PA

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Upstate Podiatry Group, PA

  • Foot & Ankle Surgery Podiatrist
  • Spartanburg, SC
  • NPI 1396487336

  Member Of

  NPD member

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e69c2bef-d9f0-4b8f-8ad3-47f8715149b1/

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Upstate Podiatry Group, PA

  • Podiatrist
  • Simpsonville, SC
  • NPI 1144660036
  NPPES parent name

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1952979890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SE MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817150",
            "telephone_number": "864-399-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W MAIN ST",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602608",
            "telephone_number": "864-399-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PODIATRY GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPSTATE PODIATRY GROUP, PA",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-399-9070"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://pwx.cernerworks.com/Citrix/ProdWeb/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "1010 W Main St",
            "city": "Laurens",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293602608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lakeisha Turner, FNP
• Lauren Allen Turner, SLP
• Susan Raines Turner, MSN, RN
• Stephanie Jill Ungaro, COTA
• Upstate Pediatric Mobility
• Upstate Podiatry Group, PA
• Alecia Van Strien
• Thinh Vo
• Miriam Elizabeth Wagner, MS CCC-SLP
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1130)

• Durable Medical Equipment & Medical Supplies in Laurens, SC
• Providers in Laurens, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.