CAROLINA PHYSICAL MEDICINE AND (NPI# 1124342506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124342506 |
| Entity Type | Organization |
| Organization Name | CAROLINA PHYSICAL MEDICINE AND |
| Other Organization Name | CORE HEALTH CENTERS-EAST SPARTANBURG |
| Practice Address |
958 E Main St Suite A Spartanburg SC 29302-2148 |
| Practice Telephone | 8645420780 |
| Practice Fax Number | 8645421689 |
| Mailing Telephone | 8645420780 |
| Mailing Fax Number | 8645421689 |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2015-06-16 |
| Authorized Official Name | STEPHANIE C WADDELL (BILLING MANAGER) |
| Authorized Official Telephone | 8644692045 |
| Authorized Official Credential | CPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | TAXONOMY CODE | 193200000X | 01 |
| Other Name | Type Code |
|---|---|
| CORE Health Centers-East Spartanburg | Doing Business As Name - Organization |
| Street Address |
958 E MAIN ST SUITE A |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457467821 | James F Richardson | Family Medicine | 958 E Main St, Suite A, Spartanburg, SC 29302-2148 | 2006-08-21 |
| 1992259139 | Carolina Wellness Clinic, LLC | Nurse Practitioner | 958 E Main St, Suite B, Spartanburg, SC 29302-2148 | 2016-08-04 |
| 1699128835 | Grey Group LLC | Social Worker | 958 E Main St, Suite B, Spartanburg, SC 29302-2148 | 2016-07-22 |
| 1285002196 | Moss Enterprise | Family Medicine | 958 E Main St, Suite A, Spartanburg, SC 29302-2148 | 2015-09-09 |
| 1346595410 | Clayton Lee Broome | Chiropractor | 958 E Main St, Suite A, Spartanburg, SC 29302-2148 | 2012-07-16 |
| 1124278049 | Stephen Paul Chasteen | Social Worker | 958 E Main St, Suite B, Spartanburg, SC 29302-2148 | 2008-09-28 |
| 1902088867 | Amanda Falls Broome | Physician Assistant | 958 E Main St, Spartanburg, SC 29302-2148 | 2007-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760903793 | Samuel Ostrum | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2017-06-29 |
| 1386164671 | Jeffrey Kyle Cooper | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2017-06-27 |
| 1518317569 | Bradley Aaron Cagle | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2016-06-20 |
| 1366857930 | Nancy Ballantyne | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2014-06-23 |
| 1508206285 | Justin Clint Black | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2013-06-26 |
| 1104892165 | Randall Steve Stewart | General Practice | 2995 Reidville Rd Ste 100, Spartanburg, SC 29301-5600 | 2006-02-28 |
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|---|---|---|---|---|
| 1053912253 | Life Essentials Health Center LLC | General Practice | 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464-3342 | 2020-11-04 |
| 1710591706 | Madhuri Khadka | General Practice | 427 Galbreath Ct, Fort Mill, SC 29708-0176 | 2020-09-07 |
| 1255945754 | Escobedo Advanced Healthcare Solutions LLC | General Practice | 121 Sparkleberry Crossing Rd Ste 200, Columbia, SC 29229-8639 | 2020-09-02 |
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1841704244 | Modern Concepts, LLC | General Practice | 1808 Second Baxter Xing Ste 108, Fort Mill, SC 29708 | 2017-11-21 |
| 1245744937 | Carolina Healthchoice of Greenville, LLC | General Practice | 274 Commonwealth Dr Ste B, Greenville, SC 29615-4872 | 2017-11-17 |
| 1861937377 | Doctors Care Sc, Pa | General Practice | 8384 Charlotte Highway, Indian Land, SC 29707-6532 | 2016-12-20 |
| 1790138014 | Beaufort-jasper-hampton Comprehensive Health Services Inc. | General Practice | 2210-b Mossy Oaks Rd., Port Royal, SC 29935-1046 | 2016-07-21 |
| 1659726438 | Inspire Medical Services | General Practice | 104 Berkeley Square Ln, Ste 63, Goose Creek, SC 29445-2958 | 2016-04-28 |
| 1609240910 | Eating Recovery Center-the Carolinas | General Practice | 12 Maple Tree Court, Suite 101, Greenville, SC 29615-4079 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
Please comment or provide details below to improve the information on CAROLINA PHYSICAL MEDICINE AND.
| 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.