EPICENTRE, LLC (NPI# 1194363580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194363580 |
| Entity Type | Organization |
| Organization Name | EPICENTRE, LLC |
| Other Organization Name | THE EPICENTRE, LLC |
| Practice Address |
2048 Charlie Hall Blvd Charleston SC 29414 |
| Practice Telephone | 8438046010 |
| Practice Fax Number | 8438049011 |
| Mailing Telephone | 8438046010 |
| Mailing Fax Number | 8438049011 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DR. KENOSHA D GLEATON (MD/OWNER) |
| Authorized Official Telephone | 8438046010 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP9552 | 05 |
| Other Name | Type Code |
|---|---|
| The EpiCentre, LLC | Doing Business As Name - Organization |
| Street Address |
2048 CHARLIE HALL BLVD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669675716 | Lowcountry Hematology & Oncology, P.a. | Specialist | 2048 Charlie Hall Blvd, Charleston, SC 29414-5830 | 2007-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750847489 | Womencare Inc | Obstetrics & Gynecology | 108 Washington St W # 201, Charleston, WV 25302-2344 | 2019-02-19 |
| 1548755788 | Catherine Anne Boniface | Obstetrics & Gynecology | 96 Jonathan Lucas St Obgyn Dept, Charleston, SC 29425 | 2018-06-29 |
| 1205356581 | Kyle Aaron Brong | Obstetrics & Gynecology | 96 Jonathan Lucas St., Ste. 634, Charleston, SC 29425 | 2017-06-27 |
| 1508215401 | Danielle Wright | Obstetrics & Gynecology | 1574 Bluewater Way, Charleston, SC 29414-7925 | 2016-06-10 |
| 1215356555 | Margaret Crosby Papadea | Obstetrics & Gynecology | 1027 Physicians Dr, Charleston, SC 29414-5350 | 2014-04-15 |
| 1770844466 | Johanna Lucy Cook | Obstetrics & Gynecology | 830 Pennsylvania Ave Ste 304, Charleston, WV 25302-3390 | 2012-05-30 |
| 1740554112 | Robert Michael Priore | Obstetrics & Gynecology | 9 Trail Hollow Dr, Charleston, SC 29414-7325 | 2012-03-02 |
| 1548555436 | Sara Janne Aarsland | Obstetrics & Gynecology | 168 Ashley Ave, Room 202 Main Hospital Msc333, Charleston, SC 29425-8907 | 2011-06-20 |
| 1164749982 | Jessica L Matheny | Obstetrics & Gynecology | 12 Courtney Dr, Charleston, WV 25304-2699 | 2010-05-04 |
| 1144467044 | Charles Winkler, M.d. | Obstetrics & Gynecology | 5 Courtney Dr, Charleston, WV 25304-2696 | 2009-01-14 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
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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.