NPIMap

Organization Active NPI

Piedmont Urgent Care Center at Baxter Village LLC

  • Urgent Care Clinic/Center
  • Fort Mill, SC
National Provider Identifier
1972590073
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PIEDMONT URGENT CARE CENTER AT BAXTER VILLAGE LLC
Practice address
502 Sixth Baxter Crossing
Fort Mill, SC 29708-6428
Phone
(803) 396-8100
Fax
(803) 396-8040
NPI assigned
Oct 4, 2005
Last updated
Sep 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Authorized official

Name
Mr. John Holland
Title
Vice President
Phone
(469) 893-2030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

502 Sixth Baxter Crossing
Fort Mill, SC 29708-6428

Mailing address

P.O. Box 741327
Atlanta, GA 30384-1327
Phone (803) 396-8100

Other identifiers 1

IdentifierTypeStateIssuer
GP3889MedicaidSC

Other names 1

  • Baxter Village Urgent Care Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1972590073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 741327",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841327",
            "telephone_number": "803-396-8100",
            "fax_number": "803-396-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 SIXTH BAXTER CROSSING",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086428",
            "telephone_number": "803-396-8100",
            "fax_number": "803-396-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT URGENT CARE CENTER AT BAXTER VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "469-893-2030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3889",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Village Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 17, 2010; 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.