SOUTHEAST REGIONAL VIRTUAL IMAGING CONSULTING ENTERPRISE PA (NPI# 1205844586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205844586 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST REGIONAL VIRTUAL IMAGING CONSULTING ENTERPRISE PA |
| Practice Address |
225 Stable Gate Dr Campobello SC 29322-8037 |
| Mailing Address |
Po Box 52990 Greenwood SC 29649-0048 |
| Practice Telephone | 8644685570 |
| Practice Fax Number | 8644685239 |
| Mailing Telephone | 8642233600 |
| Mailing Fax Number | 8642236054 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-12-21 |
| Authorized Official Name | DR. STEPHEN JACOB GORDIN (PRESIDENT) |
| Authorized Official Telephone | 8644685238 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
16566 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4506 | 05 |
| Street Address |
225 STABLE GATE DR |
| City | CAMPOBELLO |
| State | SC |
| Zip Code | 29322-8037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386668879 | Stephen J Gordin | Radiology | 225 Stable Gate Dr, Campobello, SC 29322-8037 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275923617 | Caroline Skellie | Dental Hygienist | 145 Cynthia Lane, Campobello, SC 29322 | 2015-01-23 |
| 1093870651 | Spartanburg County District One Schools | Local Education Agency (LEA) | 121 Wheeler St, Campobello, SC 29322 | 2006-12-26 |
| 1780764605 | Michael Von Baker | Specialist/Technologist | 18818 Asheville Hwy, Campobello, SC 29322 | 2006-10-16 |
| 1134288715 | Spartanburg School District One | Local Education Agency (LEA) | 121 Wheeler Street, Campobello, SC 29322-0218 | 2006-12-08 |
| 1003901406 | Diamond Pt Diabetic Suppl | Durable Medical Equipment & Medical Supplies | 149 Walker Road, Campobello, SC 29322-9053 | 2006-10-03 |
| 1073996807 | Richard Jones | Counselor | 120 Fowler Rd, Campobello, SC 29322-9115 | 2015-06-29 |
| 1922057785 | Ronald Othel Thompson | Counselor | 124 Cheyenne Ridge Trl, Campobello, SC 29322-9198 | 2006-05-09 |
| 1336315332 | Mary Arlene Marin | Massage Therapist | 145 Scenic Ave, Campobello, SC 29322-9447 | 2008-04-30 |
| 1366004095 | Timothy Nathan Scoggins | Specialist/Technologist | 190 Rubin Thorne Rd, Campobello, SC 29322-9654 | 2019-07-02 |
| 1619520202 | Autumn Nicole Anders | Registered Nurse | 247 Motlow School Rd, Campobello, SC 29322-9674 | 2019-07-23 |
| Find all providers in zip 29322 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386668879 | Stephen J Gordin | Radiology | 225 Stable Gate Dr, Campobello, SC 29322-8037 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486786 | Tara Noone | Radiology | 545 Planters Loop, Mount Pleasant, SC 29464-2743 | 2020-08-04 |
| 1447728795 | Island Imaging, LLC | Radiology | 40 Palmetto Parkway, Hilton Head Island, SC 29926 | 2018-11-05 |
| 1417423088 | Bon Secours Diagnostic Imaging | Radiology | 1 Marcus Dr Ste 100, Greenville, SC 29615-4818 | 2018-10-22 |
| 1700352374 | Bon Secours Diagnostic Imaging | Radiology | 2 Innovation Dr Ste 350, Greenville, SC 29607-5269 | 2018-10-22 |
| 1548797533 | Gregory S Connor, Md, Pa | Radiology | 628 W Home Ave, Hartsville, SC 29550-4430 | 2017-05-22 |
| 1407393861 | Mcleod Physician Associates II | Radiology | 1116 W Evans St, Florence, SC 29501-3320 | 2017-01-24 |
| 1932651908 | Long Bay Diagnostic Imaging Murrells Inlet, LLC | Radiology | 4407 Highway 17 Bypass, Murrells Inlet, SC 29576-5097 | 2016-10-26 |
| 1245687540 | John Frederick Hughes | Radiology | 96 Jonathan Lucas St # 323, Charleston, SC 29425-3230 | 2016-05-17 |
| 1295104073 | Arthur Knight Walter | Radiology | 737 River Rd, Columbia, SC 29212-8809 | 2015-09-22 |
| 1386030021 | Shawn Hobby | Radiology | 96 Jonathan Lucas St Charleston Sc 29425, Charleston, SC 29425-0001 | 2015-04-09 |
| Find all providers with the same taxonomy | ||||
| City | CAMPOBELLO |
| Zip Code | 29322 |
Please comment or provide details below to improve the information on SOUTHEAST REGIONAL VIRTUAL IMAGING CONSULTING ENTERPRISE PA.
| 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.