CORDRAY PLASTIC SURGERY LLC (NPI# 1225577265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225577265 |
| Entity Type | Organization |
| Organization Name | CORDRAY PLASTIC SURGERY LLC |
| Practice Address |
44 Folly Road Blvd Ste C Charleston SC 29407-7559 |
| Practice Telephone | 8437182334 |
| Practice Fax Number | 8432772067 |
| Mailing Telephone | 8437182334 |
| Mailing Fax Number | 8432772067 |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | DR. TRACY L CORDRAY (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8437182334 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 22185 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SOLE PROPRIETOR NPI-TYPE 1 | 1346432614 | 01 | |
| SC | 30236309 | 05 | |
| STATE LICENSE | 22185 | 01 |
| Street Address |
44 FOLLY ROAD BLVD STE C |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407-7559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432614 | Tracy Leigh Cordray | Plastic Surgery | 44 Folly Road Blvd Ste C, Charleston, SC 29407-7559 | 2007-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432614 | Tracy Leigh Cordray | Plastic Surgery | 44 Folly Road Blvd Ste C, Charleston, SC 29407-7559 | 2007-08-10 |
| 1689755472 | Jeffrey Norman Thaxton | Plastic Surgery | 505 Capitol St Ste 100, Charleston, WV 25301-1204 | 2006-10-18 |
| 1194815704 | Marga Faith Massey | Plastic Surgery | 125 Doughty St Ste 590, Charleston, SC 29403-5744 | 2006-10-13 |
| 1639288228 | Fredric D Schuh | Plastic Surgery | 65 Gadsden St, Charleston, SC 29401-1145 | 2006-08-29 |
| 1972510873 | Integrated Health Care Providers, Inc. | Plastic Surgery | 210 Brooks St Ste 200, Charleston, WV 25301-1848 | 2006-08-02 |
| 1871513150 | Peter C Devito | Plastic Surgery | 1050 Saint Andrews Blvd, Charleston, SC 29407-7173 | 2006-07-20 |
| 1942258561 | Anne Louise Edwards | Plastic Surgery | 2097 Henry Tecklenburg Drive, Suite 322 West, Charleston, SC 29414 | 2006-05-05 |
| 1114986031 | Fred T. Pulido Jr. | Plastic Surgery | 1213 Virginia St E, Third Floor, Charleston, WV 25301-2908 | 2006-03-20 |
| 1447257035 | William Andrew Stewart | Plastic Surgery | 505 Capitol St, Charleston, WV 25301-1204 | 2005-06-28 |
| 1093316184 | Taylor Mackenzie Summers | Plastic Surgery | 210 Brooks St Ste 200, Charleston, WV 25301-1848 | 2020-11-04 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
Please comment or provide details below to improve the information on CORDRAY PLASTIC SURGERY LLC.
| 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.