Organization Active NPI

Terrell L Stone

Doing business as St Matthews Family Practice

  • Rural Health Clinic/Center
  • St Matthews, SC
National Provider Identifier
1992911127
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
13583 Issued in SC
Legal business name
TERRELL L STONE
Doing business as
St Matthews Family Practice
Practice address
725 Harry C Raysor Dr
St Matthews, SC 29135-8403
Phone
(803) 874-3902
Fax
(803) 874-3905
NPI assigned
May 15, 2007
Last updated
Jul 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Authorized official

Name
Terrell L Stone, MD
Title
Owner
Phone
(803) 874-3902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 13583 SC Primary

Addresses

Primary practice location

725 Harry C Raysor Dr
St Matthews, SC 29135-8403

Mailing address

P O Box 638
725 Harry C Raysor Drive
St Matthews, SC 29135-0638
Phone (803) 874-3902

Other identifiers 1

IdentifierTypeStateIssuer
RHC076MedicaidSC

Other names 1

  • St Matthews Family Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Matthews Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1992911127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 638",
            "address_2": "725 HARRY C RAYSOR DRIVE",
            "city": "ST MATTHEWS",
            "state": "SC",
            "postal_code": "291350638",
            "telephone_number": "803-874-3902",
            "fax_number": "803-874-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HARRY C RAYSOR DR",
            "city": "ST MATTHEWS",
            "state": "SC",
            "postal_code": "291358403",
            "telephone_number": "803-874-3902",
            "fax_number": "803-874-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRELL L STONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "TERRELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-874-3902",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": "13583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC076",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Matthews Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Matthews, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.