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 | 1041C0700X | Social Worker | Clinical | | | No |
| 2 | 207Q00000X | Family Medicine | | | | No |
| 3 | 207R00000X | Internal Medicine | | | | No |
| 4 | 2081N0008X | Physical Medicine & Rehabilitation | Neuromuscular Medicine | | | No |
| 5 | 2081P0004X | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | | | No |
| 6 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | | | No |
| 7 | 208D00000X | General Practice | | | | No |
| 8 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
| 9 | 363L00000X | Nurse Practitioner | | | | No |
| 10 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 11 | 111N00000X | Chiropractor | | 3044 | SOUTH CAROLINA | Yes |