Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207X00000X | Orthopaedic Surgery | | 5521 | SOUTH CAROLINA | No |
| 2 | 207XX0004X | Orthopaedic Surgery | Foot and Ankle Surgery | 5521 | SOUTH CAROLINA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 200025994 | OTHER | SOUTH CAROLINA | RRMCARE NUMBER |
| 2 | 20076508 | OTHER | SOUTH CAROLINA | SELECT HEALTH DME |
| 3 | 570634057 | OTHER | SOUTH CAROLINA | TAX ID |
| 4 | 620405 | OTHER | SOUTH CAROLINA | SELECT HLTH NUMBER |
| 5 | D043 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP MEDICARE PTAN |
| 6 | GP6337 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP MEDICIAD PTAN # |
| 7 | 055219 | MEDICAID | SOUTH CAROLINA | |
| 8 | 1326287434 | OTHER | SOUTH CAROLINA | MEDICAID DME NPI |
| 9 | DU4331 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP RAILROAD MEDICARE PTAN |
| 10 | 1225006760 | OTHER | SOUTH CAROLINA | GROUP NPI |
| 11 | P01337425 | OTHER | SOUTH CAROLINA | RAILROAD MEDICARE PTAN |
| 12 | 46-2535418 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP TIN |
