SAVANNAH ROOF (NPI# 1154808525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154808525 |
| Entity Type | Individual |
| Full Name | SAVANNAH ROOF |
| Credential | PA |
| Practice Address |
166 Stoneridge Dr Columbia SC 29210-8239 |
| Practice Telephone | 8034613000 |
| Mailing Telephone | 8034613000 |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2019-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 945 N 5th St, Albemarle, NC 280013417 | 9803237790 | |
| 100 Medical Park Dr, Suite 110, Concord, NC 280252948 | 7044036826 | |
| 4525 Cameron Valley Pkwy, Suite 3500, Charlotte, NC 282114369 | 7043028300 | |
| 1550 Faulk St, Monroe, NC 281125086 | 9804420430 | |
| 1401 Matthews Township Pkwy, Suite 208, Matthews, NC 281055402 | 7043211002 | |
| 10826 Mallard Creek Rd, Suite 100, Charlotte, NC 282627782 | 7045930244 |
| Street Address |
166 STONERIDGE DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29210-8239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912988536 | Mary Audrey Ackerman | Internal Medicine | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2005-11-10 |
| 1467893891 | Kitra Nichols | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2013-07-15 |
| 1467899534 | Leonid Zamdborg | Radiology | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2013-05-30 |
| 1174864466 | Shelly K Goins | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2013-03-12 |
| 1629317920 | Ijan W House | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2013-02-06 |
| 1568725810 | Kevin Blas | Radiology | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2012-06-21 |
| 1467719732 | Amy Furmanski Ballou | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2012-04-11 |
| 1962799452 | Kurt Davin Meyer | Radiology | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2011-07-05 |
| 1639475098 | Garland Pearson Ames | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2011-02-02 |
| 1376855981 | Brandon M Stone | Radiology | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2010-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700413838 | Alexis Koreema Brown | Social Worker | 3205 Montcrest Rd., Columbia, SC 29210 | 2020-03-26 |
| 1942767843 | Thomas Edwin Cromer | Social Worker | 409 Evelyn Drive, Columbia, SC 29210 | 2019-02-27 |
| 1184193542 | Helen Hoffman Coleman | Pharmacist | 16 Berryhill Road, Ste 109, Columbia, SC 29210 | 2018-11-15 |
| 1356828040 | Latia Kelly Mcdonald | Counselor | 105 Beth Hope Lane, Columbia, SC 29210 | 2018-07-25 |
| 1356892848 | Butterfly Effects LLC | Community/Behavioral Health | 1607 Bentley Court, Columbia, SC 29210 | 2016-10-19 |
| 1114373651 | Lilian Emetu | Nurse Practitioner | 822 Statler Road, Columbia, SC 29210 | 2016-05-13 |
| 1154776433 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 507 Piney Grove Rd, Columbia, SC 29210 | 2016-04-25 |
| 1790167690 | Wanda Al-lahabi | Specialist | 1030 St. Andrews Rd., Suite B-3, Columbia, SC 29210 | 2015-06-26 |
| 1285040279 | Debra R. Smart | Counselor | 652 Bush Road, Suite 216, Columbia, SC 29210 | 2014-07-10 |
| 1144665282 | Snf Transportation LLC | Home Health | 810 Dutch Center Blvd, Columbia, SC 29210 | 2013-05-02 |
| Find all providers in zip 29210 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392495 | Stephanie Meyer | Physician Assistant | 5 Medical Park Road Palmetto Health, Columbia, SC 29203 | 2017-12-18 |
| 1629434279 | Jennifer Templeton | Physician Assistant | 110 Highland Center Drive, Columbia, SC 29203 | 2016-01-12 |
| 1184023871 | Candace Parker Fleming | Physician Assistant | 109 W Legion Ave, Columbia, IL 62236-2341 | 2014-08-19 |
| 1194147470 | Frederick Parker | Physician Assistant | 9 Richland Medical Park Drive, Suite 450, Columbia, SC 29203 | 2014-01-06 |
| 1780999037 | Spectrum Pain Clinics, Inc | Physician Assistant | 230 East James Campbell Blvd, Suite 102, Columbia, TN 38401 | 2010-08-11 |
| 1770728834 | Joan Chandler Hornick | Physician Assistant | 2 Medical Park Rd Ste 404, Columbia, SC 29203-6875 | 2008-12-03 |
| 1164683926 | Kimberly Shirk | Physician Assistant | 612 Saint Andrews Rd Ste 2, Columbia, SC 29210-5120 | 2008-06-24 |
| 1295869485 | Karen Traynham | Physician Assistant | 303 N Keene St Ste 301, Columbia, MO 65201-7193 | 2007-03-16 |
| 1508926817 | Nina D Garcia | Physician Assistant | 8850 Columbia 100 Pkwy Ste 316, Columbia, MD 21045-2377 | 2006-12-11 |
| 1467526418 | Tamenia Bluford Bluford | Physician Assistant | 4 N Bay Xing, Columbia, SC 29229-7507 | 2006-11-20 |
| Find all providers in COLUMBIA | ||||
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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.