SOUTH CAROLINA PROVIDER SERVICES (NPI# 1003413469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003413469 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA PROVIDER SERVICES |
| Practice Address |
413 Wildflower Rd Easley SC 29642-8642 |
| Practice Telephone | 8646507475 |
| Mailing Telephone | 8646507475 |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-10-07 |
| Authorized Official Name | GWENDELL KELLEY (OWNER) |
| Authorized Official Telephone | 8646507475 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
413 WILDFLOWER RD |
| City | EASLEY |
| State | SC |
| Zip Code | 29642-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1437648904 | Onsite Healthcare and Wellness LLC | Nurse Practitioner | 217 Sheffield Ct, Easley, SC 29642 | 2018-05-09 |
| 1477073476 | Aubre True | Specialist/Technologist | 124 Century Oaks Dr, Easley, SC 29642 | 2017-06-21 |
| 1912439944 | First Physical Therapy, LLC | Clinic/Center | 3613 Sc 153, Suite 200, Powdersville, SC 29642 | 2017-03-29 |
| 1801146485 | Sara Michele Calvert | Pharmacist | 1063 South Pendleton Street, Easley, SC 29642 | 2012-09-11 |
| 1023365251 | Heather Lilley | Pharmacist | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2012-08-07 |
| 1942590088 | Mallorie Bryan Costner | Speech-Language Pathologist | 507 Huntington Road, Easley, SC 29642 | 2011-04-11 |
| 1225352339 | Jon Lawrence Rhoden | Pharmacist | 320 Watson Road, Easley, SC 29642 | 2010-03-18 |
| 1386865350 | Gordon David Dannelly | Dentist | 701 Brushy Creek Road, Easley, SC 29642 | 2007-05-01 |
| 1538280755 | Michelle Leigh Tucker | Obstetrics & Gynecology | 1351 Crestview Road, Easley, SC 29642 | 2007-04-03 |
| Find all providers in zip 29642 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942693387 | Devon Donnelly Sharkey | Nurse Practitioner | 109 Fleetwood Dr, Suite A, Easley, SC 29640-2019 | 2015-03-10 |
| 1992085401 | Tomeka Payton | Nurse Practitioner | 101 Grace Dr, Easley, SC 29640-9088 | 2011-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898038 | Latoya Gibson | Nurse Practitioner | 48 Centennial Way, Greenville, SC 29605-4662 | 2020-10-12 |
| 1578173555 | Amy Kelly | Nurse Practitioner | 115 N Sumter St Ste 300, Sumter, SC 29150-4967 | 2020-08-05 |
| 1588293278 | Kimberly Dianne Billie Jackson | Nurse Practitioner | 940 Morningside Dr, Sumter, SC 29153-7724 | 2020-04-04 |
| 1427696475 | Porscha Rush | Nurse Practitioner | 1040 Frye Rd, Galivants Ferry, SC 29544-8018 | 2019-12-19 |
| 1306483011 | Julie Marie Sim | Nurse Practitioner | 35 Bill Fries Dr Bldg F, Hilton Head Island, SC 29926-2731 | 2019-12-02 |
| 1144780909 | Chantal Pilar Debreceny | Nurse Practitioner | 1167 Basketweave Drive, #204, Mount Pleasant, SC 29466 | 2019-03-20 |
| 1396225769 | Kristin Claude | Nurse Practitioner | 421 Se Main St Ste 100, Simpsonville, SC 29681-2697 | 2018-08-15 |
| 1376031732 | Migina Anica Timpson | Nurse Practitioner | 317 Saint Francis Dr Ste 220, Greenville, SC 29601-3976 | 2018-05-01 |
| 1932601903 | Jamie Andrews Odom | Nurse Practitioner | 2720 Sunset Blvd Ste 300, West Columbia, SC 29169-4810 | 2018-03-06 |
| 1912406026 | Darrell Quick | Nurse Practitioner | 2145 Carriage Place Dr, Florence, SC 29505-6865 | 2018-02-04 |
| Find all providers with the same taxonomy | ||||
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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.