ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA — NPI 1528018264 (Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) in MULLINS, SC)

CMS-1500 Box 24J / 33a • NPI

1528018264

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208800000X (CMS 34)

Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)

Box 32 Service Location & ZIP+4

2835 E HWY 76, SUITE 3, MULLINS, SC, 29574

Official NPPES Practice Location

Practice Phone & Referral Fax

(843) 423-4777

Fax: (843) 423-0802

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1528018264 (ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1528018264` (NPI-2 Organization / Facility)
Provider / Legal Name	ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA
Plain-English Specialty	Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) NUCC Code: `208800000X` (Urology)
Certifying / Licensing Body	American Board of Urology (ABU)
Practice Location Address	2835 E HWY 76, SUITE 3, MULLINS, SC, 29574
Practice Telephone / Fax	Tel: (843) 423-4777 \| Fax: (843) 423-0802
Administrative Mailing Address	2835 E HWY 76, MULLINS, SC, 29574
Enumeration & Last Sync	Enumerated: 2006-05-11 \| CMS Record Updated: 2020-08-22
Authorized Official	GLENN GANGI (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2835 E HWY 76, SUITE 3, MULLINS, SC, 29574

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Plain-English Taxonomy & CMS Crosswalk (208800000X)

What Does Taxonomy Code 208800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208800000X translates to:
"Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 34 (Physician/Urology)
Certifying / Accrediting Authority: American Board of Urology (ABU)
Clinical Scope: Kidney stones causing flank pain, blood in urine (hematuria), recurrent urinary tract infections (UTIs), prostate enlargement, or urinary incontinence.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA)

Typical CPT / Diagnostic Procedures:

Diagnostic Cystourethroscopy (CPT 52000) & Urodynamic Flow Studies
Ureteroscopy with Holmium Laser Lithotripsy for Kidney Stones (CPT 52356)
Extracorporeal Shock Wave Lithotripsy (ESWL — CPT 50590)
Prostate Specific Antigen (PSA) Screening & Ultrasound-Guided Biopsy

Common Therapeutic Classes:

Alpha-Blockers (Tamsulosin, Alfuzosin) for BPH & Ureteral Stone Passage
5-Alpha Reductase Inhibitors (Finasteride, Dutasteride)
Targeted Urinary Antimicrobials (Nitrofurantoin, Fosfomycin, Ciprofloxacin, Septra)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208800000X` — Urology Plain English: Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADULT & PEDIATRIC UROLOGY CENTER OF THE CAROLINAS PA (NPI #1528018264)