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EDISTO OBGYN PA
NPI 1467407155
Obstetrics & Gynecology in Orangeburg, SC

Active since May 23, 2006
1175 COOK RD, SUITE 305, ORANGEBURG, SC 29118(803) 536-9390(803) 533-0911 Get Directions Write a Review

NPPES record last updated: January 9, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edisto Obgyn Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDISTO OBGYN PA (NPI 1467407155) is a healthcare organization registered as an obstetrics & gynecology in Orangeburg, South Carolina and active in the NPI registry since May 2006. The organization lists Jerome B Degen, President, as its authorized official.

NPPES Registry Identity

NPI1467407155
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameEDISTO OBGYN PA
Location Address1175 COOK RD, SUITE 305Orangeburg, SC 29118
Mailing Address1175 Cook Rd, Suite 305Orangeburg, SC 29118 · (803) 536-9390 · Fax (803) 533-0911
Phone(803) 536-9390
Fax(803) 533-0911
Organization SubpartNo
Authorized OfficialJerome B DegenPresident · (803) 536-9390
Enumeration DateMay 23, 2006
Last NPPES UpdateJanuary 9, 2008
✔ NPI 1467407155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in SC · 07054
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1175 COOK RD, Orangeburg, SC 29118
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Other Identifiers 4

Medicaid070540SC
Medicare PIN2065SC
Medicare ID-Type UnspecifiedC609922065SC
Medicare UPINC60992

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVERETTE ARDEN WEATHERS MD
Surgery
1175 COOK RD, SUITE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 536-2555
INTERNAL MEDICINE & INFECTIOUS DISEASES SPECIALISTS
Specialist
1175 COOK RD, SUITE 115
ORANGEBURG, SC 29118
Orangeburg County (803) 531-2677
DR. BRENT J KLINGER DMD
Oral & Maxillofacial Surgery
1175 COOK RD, SUITE 135
ORANGEBURG, SC 29118
Orangeburg County (803) 534-5444
SARA ROSE PETERS PA-C
Physician Assistant
1175 COOK RD, SUITE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 395-3900
LISA GORDON FNP
Nurse Practitioner (Family)
1175 COOK RD, SUITE 230
ORANGEBURG, SC 29118
Orangeburg County (803) 395-3900
RICHARD RICHARDSON SR. M.D.
Specialist
1175 COOK RD
ORANGEBURG, SC 29118
Orangeburg County (803) 534-0033
DR. MARK JOSEPH KRZYSTON M.D.
Internal Medicine (Cardiovascular Disease)
1175 COOK RD, STE 225
ORANGEBURG, SC 29118
Orangeburg County (803) 534-8723
ORANGEBURG ORAL SURGERY & IMPLANT CENTER
Dentist (Oral and Maxillofacial Pathology)
1175 COOK RD, STE 135
ORANGEBURG, SC 29118
Orangeburg County (803) 534-5444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edisto Obgyn PA's NPI number?

The NPI number for Edisto Obgyn PA is 1467407155. It was assigned to this organization in the NPPES registry on May 23, 2006.

Where is Edisto Obgyn PA located?

Edisto Obgyn PA is located at 1175 Cook Rd Suite 305, Orangeburg, SC 29118. The listed phone number is (803) 536-9390.

What is Edisto Obgyn PA's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Edisto Obgyn PA was last updated on January 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.