PLASTIC SURGERY ASSOCIATES OF GREENVILLE LLC (NPI# 1104026541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104026541 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY ASSOCIATES OF GREENVILLE LLC |
| Practice Address |
24 Memorial Medical Dr Greenville SC 29605-4452 |
| Practice Telephone | 8642954160 |
| Mailing Telephone | (864) 295-4160 |
| Mailing Fax Number | 8642950445 |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2017-08-16 |
| Authorized Official Name | RHONDA NORRIS (OFFICE MANAGER) |
| Authorized Official Telephone | 8642954160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
9152 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PC1798 | 05 |
| Street Address |
24 MEMORIAL MEDICAL DR |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396714713 | John Barry Bishop | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605-4452 | 2006-03-16 |
| 1255766788 | Riverside Plastic Surgery LLC | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605 | 2013-09-03 |
| 1740585884 | St Francis Physician Services Inc | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605-4452 | 2011-01-21 |
| 1306042254 | Brent Moister | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605 | 2007-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396714713 | John Barry Bishop | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605-4452 | 2006-03-16 |
| 1255766788 | Riverside Plastic Surgery LLC | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605 | 2013-09-03 |
| 1740585884 | St Francis Physician Services Inc | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605-4452 | 2011-01-21 |
| 1457521668 | Joseph Cart Debrux Jr. | Surgery | 31 Medical Ridge Dr, Greenville, SC 29605-4268 | 2008-03-04 |
| 1306042254 | Brent Moister | Surgery | 24 Memorial Medical Dr, Greenville, SC 29605 | 2007-06-26 |
| 1396768990 | John H Brown | Surgery | 53 N Main St, Greenville, PA 16125-1809 | 2006-07-25 |
| 1477573228 | Greenville Plastic Surgery Associates, Ltd | Surgery | 53 N Main St, Greenville, PA 16125-1809 | 2006-07-21 |
| 1689615429 | James Lyman Fowler | Surgery | 200 Patewood Dr, Suite B480, Greenville, SC 29615-3593 | 2006-06-10 |
| 1215977376 | James Gilbert Wallace | Surgery | 31 Medical Ridge Dr, Greenville, SC 29605-4268 | 2006-06-07 |
| 1225094659 | Karen M Buckley | Surgery | 517 Moye Blvd Fl 3, Ecu Physicians Plastic Surgery Moye Medical Center #2, Greenville, NC 27834-2849 | 2006-04-25 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
Please comment or provide details below to improve the information on PLASTIC SURGERY ASSOCIATES OF GREENVILLE LLC.
| 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.