Active NPI
South Charlotte Plastic Surgery, LLC
- Plastic and Reconstructive Surgery Physician
- Rock Hill, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- Legal business name
- SOUTH CHARLOTTE PLASTIC SURGERY, LLC
- Practice address
- 1721 Ebenezer Rd Ste 115
Rock Hill, SC 29732-1119 - Phone
- (843) 898-8058
- Fax
- (843) 405-7021
- NPI assigned
- May 15, 2019
- Last updated
- May 7, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Diegidio, MD
- Title
- Owner
- Phone
- (843) 898-8058
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | Primary |
Addresses
Primary practice location
1721 Ebenezer Rd Ste 115
Rock Hill, SC 29732-1119
Mailing address
1721 Ebenezer Rd Ste 115
Rock Hill, SC 29732-1119
Phone (843) 898-8058
Other practice location 1
802 Green Valley Rd Ste 108
Greensboro, NC 27408-7099
Phone (843) 898-8058
Other practice location 2
9336 Blakeney Centre Dr Ste 130
Charlotte, NC 28277-6667
Phone (843) 898-8058
National Provider Directory
National Provider DirectoryLocations
9336 Blakeney Centre Dr
Ste 130
Charlotte, NC 28277
Phone (704) 542-8686
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Plastic and Reconstructive Surgery Physician
- Rock Hill, SC
- NPI 1780971135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1588809600000",
"number": "1982260980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 EBENEZER RD STE 115",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321119",
"telephone_number": "843-898-8058",
"fax_number": "843-405-7021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 EBENEZER RD STE 115",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321119",
"telephone_number": "843-898-8058",
"fax_number": "843-405-7021"
}
],
"practiceLocations": [
{
"address_1": "802 Green Valley Rd Ste 108",
"address_purpose": "LOCATION",
"city": "Greensboro",
"state": "NC",
"postal_code": "274087099",
"country_code": "US",
"telephone_number": "843-898-8058",
"fax_number": "843-405-7021",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9336 Blakeney Centre Dr Ste 130",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282776667",
"country_code": "US",
"telephone_number": "843-898-8058",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SOUTH CHARLOTTE PLASTIC SURGERY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-15",
"last_updated": "2020-05-07",
"certification_date": "2020-05-07",
"status": "A",
"authorized_official_last_name": "DIEGIDIO",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "843-898-8058",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
- South Carolina Dept of Mental Health Accounting Office (Synergy Health & Wellness at Catawba CMHC)
- South Carolina Dept of Mental Health Accounting Office (Catawba Mental Health Center)
- South Carolina Emergency Physicians, LLC
- South Carolina Homecare, LLC (Home Health Care of South Carolina - Piedmont)
- South Carolina Progressive Living
- South End Pharmacy
- Southeast Pulmonary and Critical Care LLC
- Southeastern Medical Associates, LLC
- Southern Home Care Services, Inc. (All Ways Caring HomeCare)
- Southern Psychiatric Practice
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.