Individual provider Active NPI

Samuel Davis, MD

  • Orthopaedic Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1972779692
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2014-01317 Issued in NC
Practice address
134 Professional Park Dr
Rock Hill, SC 29732-1178
Phone
(803) 329-3130
NPI assigned
May 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 36553 SC
Orthopaedic Surgery Physician 207X00000X 2014-01317 NC Primary

Addresses

Primary practice location

134 Professional Park Dr
Rock Hill, SC 29732-1178

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1690 Highway 160 W
Fort Mill, SC 29708-8024
Phone (803) 548-2424

Other practice location 2

10660 Park Rd
Ste 3100
Charlotte, NC 28210-8413
Phone (704) 667-8750

Other practice location 3

1201 Colonial Commons Ct
Lancaster, SC 29720-2210
Phone (803) 329-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140604000103 SC Practitioner - Orthopedic Surgery 5698808848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Palmetto Bone and JointGroup PAC ID 4385545565, 12 clinicians

Practice addresses (Care Compare)

104 Ellett Rd
Chapin, SC 29036-8604
Phone (864) 833-3046

22971 Hwy 76 E
Clinton, SC 29325
Phone (864) 833-3046

2704 Kinard St
Newberry, SC 29108-2908
Phone (803) 321-6254

Hospital & facility affiliations

  • Amedisys Home Health of Lexington Home health agency, Lexington, SC, CCN 427039
  • Newberry County Memorial Hospital Hospital, Newberry, SC, CCN 420053
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion147
Laminectomy or laminotomy (partial removal of spine bones)74
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-01317NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Bone and Joint Orthopaedic Surgery CurrentSince Mar 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Orthopaedic Surgery CurrentSince Aug 1, 2016 Accepting new patients

Locations

104 Ellett Rd
Chapin, SC 29036
Phone (803) 567-8970

22971 Highway 76 E
Clinton, SC 29325
Phone (803) 833-3046

1690 Highway 160 W
Fort Mill, SC 29708
Phone (803) 547-7541

1 Wellness Blvd
Ste 202
Irmo, SC 29063
Phone (803) 470-7040

1201 Colonial Commons Ct
Lancaster, SC 29720
Phone (803) 286-8443

2704 Kinard St
Newberry, SC 29108
Phone (803) 321-6254

134 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3130

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1972779692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 PROFESSIONAL PARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321178",
            "telephone_number": "803-329-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Highway 160 W",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297088024",
            "country_code": "US",
            "telephone_number": "803-548-2424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "704-667-8750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Colonial Commons Ct",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "SC",
            "postal_code": "297202210",
            "country_code": "US",
            "telephone_number": "803-329-3130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "36553",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2014-01317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.