Pageland Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PAGELAND FAMILY MEDICINE

Practice address

301 N Van Lingle Mungo Blvd
Pageland, SC 29728

Phone

(843) 672-6127

Fax

(843) 672-5748

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Daniel L Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Carolinas Physicians Network Inc

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Charlotte, NC
  • NPI 1396886099

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  • Orthopaedic Surgery Physician
  • Denver, NC
  • NPI 1477884302

  Member Of

  NPD member

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992735989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AIRPORT CENTER PKWY STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085899",
            "telephone_number": "704-512-4116",
            "fax_number": "704-371-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N VAN LINGLE MUNGO BLVD",
            "city": "PAGELAND",
            "state": "SC",
            "postal_code": "29728",
            "telephone_number": "843-672-6127",
            "fax_number": "843-672-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGELAND FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1123",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jana M. Mallder, CRNP
• Medna Cares
• O and B Care
• Pageland Chiropractic Office, PA
• Pageland Dentistry PA
• Pageland Rescue Squad
• Palmetto Oaks Residential Care
• Peaceful Pathways Coaching & Care, LLC
• Poplar Springs Assisted Living
• Charles T. Powell Jr., D.M.D.

• Family Medicine Physician in Pageland, SC
• Providers in Pageland, 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 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.