{"npi":"1073072468","type":"NPI-2","status":"active","name":{"display":"Newberry Surgical LLC","other":[],"organization_name":"NEWBERRY SURGICAL LLC","authorised_official":"William Cantey"},"specialty":{"primary_taxonomy":"208600000X","primary_taxonomy_description":"Surgery","slug":"surgery","schema_org_specialty":"Surgical","all":[{"code":"208600000X","description":"Surgery","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2660 KINARD ST","city":"NEWBERRY","state":"SC","postal_code":"291082912","country_code":"US","phone":"9122784819"},{"purpose":"MAILING","street_1":"2660 KINARD ST","city":"NEWBERRY","state":"SC","postal_code":"291082912","country_code":"US","phone":"8035975225","fax":"8035975228"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"188175","state":"SC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20190516003168","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"SC","pac_id":"3971846825"}]},"enumeration_date":"2019-03-15","last_updated":"2024-06-28","_meta":{"source":"NPPES","snapshot_date":"2024-06-28","doc_url":"https://findmynpi.com/api"}}