PHYLLIS RAYNOR (NPI# 1265804066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265804066 |
| Entity Type | Individual |
| Full Name | PHYLLIS RAYNOR |
| Practice Address |
2900 Sunset Blvd West Columbia SC 29169-3422 |
| Mailing Address |
206 Cedar View Dr Irmo SC 29063-7929 |
| Practice Telephone | 8037969911 |
| Mailing Telephone | 8034665082 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN19777 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2900 SUNSET BLVD |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-3422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427044957 | Three Rivers Behavioral Health LLC | Psychiatric Hospital | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2005-09-20 |
| 1447898010 | Tamara Jacquelyn Wright | Social Worker | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2019-12-13 |
| 1588217368 | Emmy Margaret Boring | Counselor | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2019-07-20 |
| 1639557135 | Alicia Patricia Harris | Counselor | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2015-05-15 |
| 1841586187 | Three Rivers Behavioral Health LLC | Psychiatric Hospital | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2011-06-24 |
| 1013229855 | Atit Bhattachan | Psychiatry & Neurology | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2010-07-09 |
| 1013178334 | Tiona Guess Praylow | Psychiatry & Neurology | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2008-06-19 |
| 1104835537 | Psych M.d. Associates LLC | Psychiatric Hospital | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2006-08-05 |
| 1073509055 | Three Rivers Behavioral Care, LLC | Clinic/Center | 2900 Sunset Blvd, West Columbia, SC 29169-3422 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538695846 | Cerrissa Hugie | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-05-05 |
| 1821492869 | Melissa Gambrell | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc., West Columbia, SC 29169 | 2014-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831708296 | The Integrated Wellness Center, LLC | Nurse Practitioner | 738 W Liberty St Ste B, Sumter, SC 29150-4745 | 2020-07-30 |
| 1033737903 | Danielle Ledwell | Nurse Practitioner | 109 Bee St Fl 5, Charleston, SC 29401-5703 | 2020-07-08 |
| 1821612615 | Hannah Olivia Robidoux | Nurse Practitioner | 109 Montelena Dr, Lexington, SC 29072-6911 | 2020-06-08 |
| 1376172502 | Luron M Fleming | Nurse Practitioner | 712 Arlington Ave, Greenville, SC 29601-3206 | 2020-04-08 |
| 1760017651 | Kandice Rivers | Nurse Practitioner | 8504 Chloe Ln, North Charleston, SC 29406-8100 | 2020-03-11 |
| 1194350447 | Angela M. Strange | Nurse Practitioner | 109 Brookhaven Dr, Moore, SC 29369-9750 | 2020-03-06 |
| 1144851742 | Patricia Deane | Nurse Practitioner | 430 Cox Rd, Greer, SC 29651-7260 | 2020-02-01 |
| 1497386155 | Michelle Yvette Pinckney | Nurse Practitioner | 1094 Williams Rd, Charleston, SC 29412-5322 | 2020-01-31 |
| 1619515632 | Leah R Hunter | Nurse Practitioner | 53 Antique Rose Ct, Irmo, SC 29063-7501 | 2019-12-20 |
| 1275175093 | Carrie Laxton Ballenger | Nurse Practitioner | 2094 Woodruff Road, Greenville, SC 29607 | 2019-10-14 |
| Find all providers with the same taxonomy | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.