NPIMap

Organization Active NPI

Infinite Wellness Center

  • Internal Medicine Physician
  • Fort Mill, SC
National Provider Identifier
1962772764
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
943 Issued in SC
Legal business name
INFINITE WELLNESS CENTER
Practice address
1698 Highway 160 W Ste 200
Fort Mill, SC 29708-8034
Phone
(803) 547-4343
Fax
(803) 547-3914
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Ronald JohnsonNPI 1255578225
Title
President
Phone
(803) 547-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 943 SC Primary

Addresses

Primary practice location

1698 Highway 160 W Ste 200
Fort Mill, SC 29708-8034

Mailing address

1698 Highway 160 W Ste 200
Fort Mill, SC 29708-8034
Phone (803) 547-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000598 SC Part B Supplier - Clinic/Group Practice 3072773555 Receives reassigned benefits from 11 practitioners
Practice locations: Fort Mill, SC

National Provider Directory

National Provider Directory

Locations

1698 Highway 160 W
Ste 200
Fort Mill, SC 29708
Phone (803) 547-4343

1698 Highway 160 W
Ste 210
Fort Mill, SC 29708
Phone (804) 547-4343

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1962772764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 HIGHWAY 160 W STE 200",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088034",
            "telephone_number": "803-547-4343",
            "fax_number": "803-547-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 HIGHWAY 160 W STE 200",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088034",
            "telephone_number": "803-547-4343",
            "fax_number": "803-547-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-547-4343"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.