HENRY OTHERSEN JR. (NPI# 1073628913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073628913 |
| Entity Type | Individual |
| Full Name | HENRY OTHERSEN JR. |
| Credential | MD |
| Practice Address |
171 Ashley Ave Charleston SC 29425-0001 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437921414 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
3602 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 036026 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710909718 | Henry Biemann Othersen IIi | Psychiatry & Neurology | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-07-25 |
| Street Address |
171 ASHLEY AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203922 | Nicholas J Pastis Jr. | Internal Medicine | 171 Ashley Ave, Charleston, SC 29425-8900 | 2005-05-24 |
| 1760083745 | Eleta Lazar Donelan | Physician Assistant | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-11-05 |
| 1285231340 | Bree Romecki | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-10-02 |
| 1942812078 | Warren Allen James | Student in an Organized Health Care Education/Training Program | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-19 |
| 1457962060 | Rosmary Ros-demarize | Psychologist | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-08-17 |
| 1558971390 | Auryelle Ascue | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-06 |
| 1396361994 | David Gonzalez | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8911 | 2020-06-19 |
| 1003432592 | Hannah Burrick | Audiologist | 171 Ashley Ave, Charleston, SC 29425-8903 | 2020-06-19 |
| 1528683562 | Kelsey Renee Full | Emergency Medicine | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-06-16 |
| 1861017949 | Christina Lee | Anesthesiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891798799 | Deborah Louise Albert | Surgery | 830 Pennsylvania Ave Ste 202, Charleston, WV 25302-3389 | 2005-05-24 |
| 1881031557 | Integrated Health Care Providers, Inc. | Surgery | 830 Pennsylvania Ave, Suite 305, Charleston, WV 25302-3302 | 2013-06-04 |
| 1710269261 | Lucas Aaron Mcduffie | Surgery | 171 Ashley Ave, Charleston, SC 29425-5112 | 2011-09-11 |
| 1124263587 | Laura Elizabeth Hollinger | Surgery | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-12-12 |
| 1053564963 | University Medical Associates | Surgery | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| 1780809947 | Christian John Streck Jr. | Surgery | 96 Jonathan Lucas St, Suite 418 Csb Msc 613, Charleston, SC 29425-8900 | 2007-04-14 |
| 1063544922 | Robert A Cina | Surgery | 171 Ashley Ave, Charleston, SC 29425-8908 | 2007-03-09 |
| 1639284573 | Charles D Smith IIi | Surgery | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-08-20 |
| 1992779128 | Minoo N Kavarana | Surgery | 171 Ashley Ave, Charleston, SC 29425-0100 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124077524 | Laurel Paige Davis | Surgery | 1026 Barfield St, Daniel Island, SC 29492-7583 | 2006-05-10 |
| 1740250521 | Juan I Camps | Surgery | 9 Richland Medical Park Dr 500, Columbia, SC 29203-6870 | 2006-01-25 |
| 1659363133 | Robert L Gates | Surgery | 48 Cross Park Ct, Greenville, SC 29605-4263 | 2005-08-19 |
| 1154811651 | Palmetto Health - University of South Carolina Medical Group | Surgery | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2018-05-10 |
| 1699937219 | Bhairav V Shah | Surgery | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2008-06-25 |
| 1801917877 | Daniel F. Saad | Surgery | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2007-04-03 |
| 1902825532 | James Franklin Green Jr. | Surgery | 48 Cross Park Ct, Greenville, SC 29605-4263 | 2006-07-18 |
| 1629096763 | Alexander Dix Soutter | Surgery | 295a Midland Pkwy Ste 260, Summerville, SC 29485-5901 | 2006-07-17 |
| 1003844556 | Palmetto Health | Surgery | 9 Richland Medical Park Dr, Suite 500, Columbia, SC 29203-6859 | 2006-06-30 |
| 1699721431 | John Cletus Chandler | Surgery | 48 Cross Park Ct, Greenville, SC 29605-4263 | 2006-05-25 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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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.