Pediatrix Medical Group of South Carolina PA

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

Legal business name

PEDIATRIX MEDICAL GROUP OF SOUTH CAROLINA PA

Practice address

1301 Concord Ter
Sunrise, FL 33323-2843

Phone

(954) 384-0175

Fax

(954) 851-1948

NPI assigned

Sep 17, 2006

Organization subpart

No

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

Authorized official

Name

Nicolas E Glaser

Title

Assistant Secretary

Phone

(954) 384-0175

Specialties & licenses 1

Addresses

Other identifiers 10

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelley Lovell Coker, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Florence, SC
  • NPI 1164514345
  NPD (past)
• J. Thomas Cox Jr., M.D.

  • Neonatal-Perinatal Medicine Physician
  • Florence, SC
  • NPI 1447214317
  NPD (past)
• Joseph Ellsworth Harlan Jr., M.D.

  • Neonatal-Perinatal Medicine Physician
  • Florence, SC
  • NPI 1235192212
  NPD (past)
• Douglas Matthew Moeckel, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Florence, SC
  • NPI 1164691937
  NPD (past)
• John Edward Moss Jr., M.D.

  • Neonatal-Perinatal Medicine Physician
  • Florence, SC
  • NPI 1144291014
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1992802607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4991 LAKE BROOK DR",
            "address_2": "SUITE 300",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609293",
            "telephone_number": "804-346-3535",
            "fax_number": "804-253-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "954-384-0175",
            "fax_number": "954-851-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP OF SOUTH CAROLINA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "954-384-0175"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1787",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2351",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3250",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3457",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0179",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3519",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2096",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2505",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2701",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3458",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrix Medical Group of Michigan PC
• Pediatrix Medical Group of Montana, PC
• Pediatrix Medical Group of North Carolina PC
• Pediatrix Medical Group, Inc.
• Pediatrix Primary Care of Georgia, LLC
• Pediatrix Urgent Care of Georgia, LLC
• Maibis Pedroso
• Sandra Pekarek

• Neonatal-Perinatal Medicine Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Neonatal-Perinatal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.