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SPARTANBURG REGIONAL MED CTR NPI 1679514418


NPI Information

NPI: 1679514418
Provider Name: SPARTANBURG REGIONAL MED CTR

Doing Business As: PALMETTO PEDIATRICS NORTH GROVE

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1330 BOILING SPRINGS ROAD
SUITE 1300
SPARTANBURG, SC
ZIP 29303
Phone: (864) 560-6345
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SPARTANBURG REGIONAL MED CTR is a pediatrics in Spartanburg, 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. SPARTANBURG REGIONAL MED CTR NPI is 1679514418. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Palmetto Pediatrics North Grove.

The provider's business location address is:

1330 BOILING SPRINGS ROAD
SUITE 1300
SPARTANBURG, SC
ZIP 29303-204
Phone: (864) 560-6345
Fax: (864) 560-6054

The provider's authorized official is Mark Aycock .
The authorized official title is Executive Vice President and has the following contact phone number (864) 560-6000.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 4/23/2012.


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
1207W00000XOphthalmologyNo
2208000000XPediatricsYes

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
15908005MEDICAIDNORTH CAROLINA
2=========032OTHERSOUTH CAROLINATRICARE GROUP#
3GP5634MEDICAIDSOUTH CAROLINA
4=========045OTHERSOUTH CAROLINABCBS GROUP#
5GP1118MEDICAIDSOUTH 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: 4/28/2024

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