CODY ROBERTSON (NPI# 1225560675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225560675 |
| Entity Type | Individual |
| Full Name | CODY ROBERTSON |
| Practice Address |
1409 W Georgia Rd Ste B Simpsonville SC 29680-6420 |
| Mailing Address |
300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 |
| Practice Telephone | 8644545000 |
| Mailing Telephone | 8645228617 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2020-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 84922 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1409 W GEORGIA RD STE B |
| City | SIMPSONVILLE |
| State | SC |
| Zip Code | 29680-6420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144285354 | James W Robinson | Family Medicine | 1409 W Georgia Rd Ste B, Simpsonville, SC 29680-6420 | 2006-04-19 |
| 1114377058 | Julia Darby Darley | Nurse Practitioner | 1409 W Georgia Rd Ste B, Simpsonville, SC 29680-6420 | 2016-06-21 |
| 1891182887 | Henry Clarke Bynum IIi | Family Medicine | 1409 W Georgia Rd Ste B, Simpsonville, SC 29680 | 2015-04-17 |
| 1720497837 | Jennifer Elrod Knapp | Nurse Practitioner | 1409 W Georgia Rd Ste B, Simpsonville, SC 29680-6420 | 2014-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235776568 | Tribe Dental LLC | Dentist | 11 Magnolia Cove Dr, Simpsonville, SC 29680 | 2019-12-05 |
| 1255860243 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 704 Fairview Rd., Simpsonville, SC 29680 | 2017-06-05 |
| 1588061998 | Wrights Care Services LLC | Community/Behavioral Health | 504 Boyd Ave, Simpsonville, SC 29680 | 2014-12-01 |
| 1619389590 | Nina Christine Mckenzie | Speech-Language Pathologist | 303 Barrett Chase Dr, Simpsonville, SC 29680 | 2014-05-27 |
| 1275878761 | Stepping Stones Therapy Services | Speech-Language Pathologist | 501 Westbury Way, Simpsonville, SC 29680 | 2012-12-10 |
| 1295085363 | Wael D Nasr | Pharmacist | 698 Fairview Rd., Simpsonville, SC 29680 | 2012-09-14 |
| 1285984831 | Courtney Sands | Pharmacist | 914 West Georgia Road, Simpsonville, SC 29680 | 2012-09-11 |
| 1245589175 | Jeegar Patel | Pharmacist | 914 West Georgia Rd, Simpsonville, SC 29680 | 2012-09-06 |
| 1083847024 | Still Waters Therapeutic Massage & Wellness Clinic | Massage Therapist | 452 North Main St., Six Mile, SC 29680 | 2009-08-25 |
| 1104849314 | Victor Paul Lebedovych | Dentist | 634 Fairview Rd, Building C, Simspnville, SC 29680 | 2006-07-26 |
| Find all providers in zip 29680 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487174462 | Excalibur Youth Services, LLC. | Family Medicine | 3683 S Industrial Dr, Simpsonville, SC 29681-3238 | 2017-06-21 |
| 1558527416 | Spartanburg Medical Center | Family Medicine | 2801 Woodruff Rd Ste 101, Simpsonville, SC 29681-4807 | 2008-07-31 |
| 1871754689 | Dr Thomas A Malone, Md Pa | Family Medicine | 224 Ne Main St, Simpsonville, SC 29681-2318 | 2008-06-24 |
| 1164644381 | Sara Mccleave Lindsay | Family Medicine | 509 Poinsettia Drive, Simpsonville, SC 29681-3438 | 2007-05-03 |
| 1871655431 | Melody Jan Kneeland | Family Medicine | 219 Batesville Rd, Simpsonville, SC 29681-4816 | 2006-12-13 |
| 1083645584 | Fairview Family Practice | Family Medicine | 103 Fairview Pointe Dr., Simpsonville, SC 29681 | 2006-07-05 |
| 1205863107 | Keith H Waters | Family Medicine | 103 Fairview Pointe Drive, Simpsonville, SC 29681 | 2006-06-27 |
| 1134155112 | Joseph Duncan Burnette Jr. | Family Medicine | 1409 West Butler Road, Suite B, Simpsonville, SC 29680-6322 | 2006-06-23 |
| 1376589739 | Terrell T Leeke | Family Medicine | 103 Fairview Pointe Dr, Simpsonville, SC 29681-3223 | 2006-06-22 |
| 1346286846 | Daniel Adam Dillon | Family Medicine | 3930 Grandview Dr Ste B, Simpsonville, SC 29680 | 2006-06-22 |
| Find all providers in SIMPSONVILLE | ||||
| City | SIMPSONVILLE |
| Zip Code | 29680 |
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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.