Gary J Barrett MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11051 Issued in SC

Legal business name

GARY J BARRETT MD PA

Practice address

3109 Casey St
Loris, SC 29569

Phone

(843) 756-8090

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gary J Barrett, MD

Title

Owner

Phone

(843) 756-8090

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Corporation Other name

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982642880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "29569",
            "telephone_number": "843-756-8090",
            "fax_number": "843-756-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 CASEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "29569",
            "telephone_number": "843-756-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY J BARRETT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-756-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890136N",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0648",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Deanna L Fisher, CDR
• Lillian Fong, MD
• Sandra Ford, RN
• Sheri Ford
• David Edward Garces, MD
• Gateway Drug Store, Inc.
• Tamara Geralds
• Ramiro Jay Godines, M.D.
• Starlette C Godwin
• Elizabeth Porter Gore, LPC

• Internal Medicine Physician in Loris, SC
• Providers in Loris, SC by specialty
• Internal Medicine 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.