Colleton Heart Center, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

21611 Issued in SC

Legal business name

COLLETON HEART CENTER, LLC

Practice address

415 Robertson Blvd Ste C
Walterboro, SC 29488-5713

Phone

(843) 549-3400

Fax

(843) 549-1424

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan M Gregory, M.D.

Title

Owner

Phone

(843) 549-3400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972632115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROBERTSON BLVD STE C",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885713",
            "telephone_number": "843-549-3400",
            "fax_number": "843-549-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROBERTSON BLVD STE C",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885713",
            "telephone_number": "843-549-3400",
            "fax_number": "843-549-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLETON HEART CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-549-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "21611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1417940792",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216117",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleton Commission on Alcohol and Drug Abuse
• Colleton County Board of Disabilities and Special Needs
• Colleton County School District
• Colleton Courtyard
• Colleton Emergency Group PC
• Colleton Medical Anesthesia, LLC
• Colleton Medical Hospitalists LLC
• Colleton Neurology Associates LLC
• Colleton Otolaryngology, Head & Neck Surgery, LLC
• Saquanna Colter

• Cardiovascular Disease Physician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Cardiovascular Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.