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 | | 29727 | SOUTH CAROLINA | No |
| 2 | 208100000X | Physical Medicine & Rehabilitation | | 29727 | SOUTH CAROLINA | No |
| 3 | 208VP0000X | Pain Medicine | Pain Medicine | 29727 | SOUTH CAROLINA | No |
| 4 | 208VP0014X | Pain Medicine | Interventional Pain Medicine | 29727 | SOUTH CAROLINA | No |
| 5 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | 29727 | 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 | 4271747 / 1572888 | OTHER | SOUTH CAROLINA | COVENTRY NETWORKS PROVIDER NO. & CPD ID NO. |
| 2 | 42D2000692 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE CLIA CERTIFICATION NO. |
| 3 | 45168 | OTHER | SOUTH CAROLINA | MULTIPLAN GROUP NO. |
| 4 | 56162 | OTHER | SOUTH CAROLINA | MEDCOST GROUP PAYER ID |
| 5 | 570634057 | OTHER | SOUTH CAROLINA | GROUP TAX ID |
| 6 | P01291314 | OTHER | SOUTH CAROLINA | RAILROAD MEDICARE PTAN |
| 7 | 9343063 | OTHER | SOUTH CAROLINA | AETNA PROVIDER ID |
| 8 | 965426 | OTHER | SOUTH CAROLINA | WELLCARE PROVIDER ID |
| 9 | DE3528 | OTHER | SOUTH CAROLINA | MEDICAID DME PTAN |
| 10 | AA2054 | OTHER | SOUTH CAROLINA | MEDICARE NUMBER |
| 11 | DE3539 | OTHER | SOUTH CAROLINA | MEDICAID DME PTAN |
| 12 | DU4331 | OTHER | SOUTH CAROLINA | RAILROAD MEDICARE GROUP PTAN |
| 13 | 220471 | OTHER | SOUTH CAROLINA | MEDCOST PROVIDER NO. |
| 14 | 46-2535418 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP TIN |
| 15 | DE3537 | OTHER | SOUTH CAROLINA | MEDICAID DME PTAN |
| 16 | 7623566 | OTHER | SOUTH CAROLINA | CIGNA PROVIDER ID |
| 17 | AA20541701 | OTHER | SOUTH CAROLINA | MEDICARE GROUP |
| 18 | D043 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE MEDICARE GROUP PTAN |
| 19 | DE3694 | OTHER | SOUTH CAROLINA | MEDICAID DME PTAN |
| 20 | DE3538 | OTHER | SOUTH CAROLINA | MEDICAID DME PTAN |
| 21 | 1902246077 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE GROUP NPI |
| 22 | 30165827 | OTHER | SOUTH CAROLINA | SELECT HEALTH PROVIDER ID |
| 23 | GP6337 | OTHER | SOUTH CAROLINA | ARCIS HEALTHCARE MEDICAID GROUP PTAN |