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SWEETGRASS PEDIATRICS NPI 1437168135


NPI Information

NPI: 1437168135
Provider Name: SWEETGRASS PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 42D1005126

Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 764-1722
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SWEETGRASS PEDIATRICS is a pediatrics in North Charleston, SC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SWEETGRASS PEDIATRICS NPI is 1437168135. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2713 DANTZLER DR
NORTH CHARLESTON, SC
ZIP 29406-005
Phone: (843) 764-1722
Fax: (843) 764-1788

The provider's authorized official is Laura Hilton James .
The authorized official title is Office Manager and has the following contact phone number (843) 764-1722.

The CLIA number assigned to this NPI record is 42D1005126 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
120014778OTHERSOUTH CAROLINASELECT HEALTH OF SC
2GP3557MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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