Summerville Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8823 Issued in SC

Legal business name

SUMMERVILLE PRIMARY CARE

Practice address

299-A Midland Parkway
Summerville, SC 29485

Phone

(985) 413-9829

NPI assigned

Apr 19, 2013

Last updated

Aug 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Magee

Title

Practice Manager

Phone

(843) 285-7820

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

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.

• David Jay Baggett, MD

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1598838229
  Medicare reassignment
• Jan Hendrik Burger, MD

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1215001979
  NPD (past)
• Walter David Leventhal, MD

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1124192869
  NPD (past)
• Thomas Maino, M.D.

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1659323640
  NPD (past)
• Stephanie Kehoe Pitcairn, PA-C

  • Medical Physician Assistant
  • Bozeman, MT
  • NPI 1073851812
  NPD (past)

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1982048062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 MIDLAND PKWY # A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299-A MIDLAND PARKWAY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29485",
            "telephone_number": "985-413-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "MAGEE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-285-7820"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "8823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summerville Pediatric Dentistry
• Summerville Pediatric Eyecare
• Summerville Pediatric Eyecare PC
• Summerville Pediatric Occupational Therapy, LLC
• Summerville Physical Therapy & Balance Rehabilitation for Adults, LLC
• Summerville Primary Eyecare LLC (Summerville Primary Eyecare)
• Summerville Sleep Consultants LLC
• Summerville Smiles Dental Office, PC
• Summerville Surgical Associates, PA
• Summit Hand Therapy, LLC

• Family Medicine Physician in Summerville, SC
• Providers in Summerville, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.