Active NPI
Terrell L Stone
Doing business as St Matthews Family Practice
- Rural Health Clinic/Center
- St Matthews, SC
National Provider Identifier
1992911127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- License
- 13583
- 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, 2009
- 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
- Terrell L Stone, MD
- Title
- Owner
- Phone
- (803) 874-3902
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHC076 | Medicaid | SC |
Other names 1
- St Matthews Family Practice
National Provider Directory
National Provider Directory- Tax ID family
- St Matthews Family Practice
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba St Matthews Family Practice
- Clinical Medical Laboratory
- St Matthews, SC
- NPI 1790759520
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.