SUMTER MEDICAL SPECIALISTS PA (NPI# 1619069481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619069481 |
| Entity Type | Organization |
| Organization Name | SUMTER MEDICAL SPECIALISTS PA |
| Other Organization Name | CAROLINA DIABETES & KIDNEY CENTER |
| Practice Address |
635 W Wesmark Blvd Sumter SC 29150-1900 |
| Practice Telephone | 8034697500 |
| Practice Fax Number | 8034697521 |
| Mailing Telephone | 8034697500 |
| Mailing Fax Number | 8034697521 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PUSADEE SUCHINDA (OWNER, SEC/TREAS) |
| Authorized Official Telephone | 8034697500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | 20072 | SC | Allopathic & Osteopathic Physicians |
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
23697 | SC | Allopathic & Osteopathic Physicians |
| X | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
10500 | SC | Allopathic & Osteopathic Physicians |
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
10273 | SC | Allopathic & Osteopathic Physicians |
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
08460 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PA7750 | 05 | |
| SC | MEDICAID DM EDUC PROGRAM | DPE034 | 01 |
| Other Name | Type Code |
|---|---|
| CAROLINA DIABETES & KIDNEY CENTER | Other Name - Individual/Organization |
| Street Address |
635 W WESMARK BLVD |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417941501 | Leslie Andrew Beben | Physician Assistant | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2005-09-06 |
| 1083045546 | Lauren Marie Pepin | Physician Assistant | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2013-12-10 |
| 1053752683 | Yaw Boateng | Nutritionist | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2013-07-11 |
| 1962549899 | Angela Beth Whittle-merchant | Nurse Practitioner | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2007-01-31 |
| 1477636652 | Virgina W Ford | Nurse Practitioner | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-10-23 |
| 1174615868 | James R Cain IIi | Internal Medicine | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-09-29 |
| 1194817932 | Pusadee Suchinda | Internal Medicine | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-09-29 |
| 1437241262 | Usah Lilavivat | Internal Medicine | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-09-29 |
| 1699707596 | Donna L Atkinson | Registered Nurse | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-07-07 |
| 1851348064 | Jose R Salcedo-contreras | Internal Medicine | 635 W Wesmark Blvd, Sumter, SC 29150-1900 | 2006-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687338 | Colonial Family Practice, LLC | Internal Medicine | 674 W Liberty St, Sumter, SC 29150-4882 | 2019-09-11 |
| 1194145615 | Jacquelyn S. Gill | Internal Medicine | 1278 N. Lafayette Dr, Sumter, SC 29150-2664 | 2014-04-23 |
| 1578581252 | Fisher Medical Pa | Internal Medicine | 6 Barnette Dr, Sumter, SC 29150-8004 | 2006-07-18 |
| 1043292618 | Thomas E Hawkey | Internal Medicine | 12 Barnette Dr, Sumter, SC 29150-8004 | 2005-11-18 |
| 1144218009 | Andrew J. Reynolds | Internal Medicine | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 | 2005-10-13 |
| 1497743595 | Hugh T Stoddard Jr. | Internal Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-10-12 |
| 1639605231 | Mcleod Physician Associates II | Internal Medicine | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 | 2017-05-03 |
| 1689128951 | Carolina Diabetes & Kidney Center, LLC | Internal Medicine | 625 W Wesmark Blvd, Sumter, SC 29150-1900 | 2016-08-04 |
| 1699187005 | Leeann Ansica Nelson | Internal Medicine | 129 N Washington St, Sumter, SC 29150-4949 | 2014-05-20 |
| 1750721064 | Colonial Family Practice, LLC | Internal Medicine | 764 W Liberty St, Suite B, Sumter, SC 29150 | 2013-07-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.