THEODORE RAVENEL SMITH (NPI# 1275587982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275587982 |
Entity Type | Individual |
Full Name | THEODORE RAVENEL SMITH |
Credential | MD |
Practice Address |
1690 Skylyn Dr Ste 210 Spartanburg SC 29307-1075 |
Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
Practice Telephone | 8642538170 |
Practice Fax Number | 8645857787 |
Mailing Telephone | 8645604304 |
Mailing Fax Number | 8645604413 |
Enumeration Date | 2006-05-19 |
Last Update Date | 2020-11-05 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 7493 | SC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | MEDICARE RAILROAD PTAN# | P00386787 | 01 |
SC | MEDICARE PIN | SCE4946084 | 01 |
SC | 074939 | 05 | |
SC | MEDICARE PIN | SCE4946067 | 01 |
SC | MEDICARE PIN | SCE494J577 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053932111 | Theodore L Smith | Peer Specialist | 9401 Lorain Ave # 102, Cleveland, OH 44102-4726 | 2020-04-29 |
1144790627 | Theodore Roosevelt Smith | Licensed Practical Nurse | 830 Ezzard Charles Drive, Cincinnati, OH 45214 | 2018-11-28 |
1427203157 | Theodore Vandix Smith IIi | Counselor | 71-50 Parsons Blvd., Flushing, NY 11365 | 2008-11-21 |
1629228408 | Theodore Michael Smith | Massage Therapist | 13818 6760 Rd, Montrose, CO 81401-7494 | 2008-09-29 |
1558583492 | Theodore Williams Smith | Psychiatry & Neurology | 100 Edgewood Avenue N.e., Suite 1228, Atlanta, GA 30303-3068 | 2007-05-02 |
1265544340 | Theodore G. Smith | Chiropractor | 639 Old Phoenix Rd, Eatonton, GA 31024-5610 | 2006-08-31 |
1477152924 | Theodore Smith | Social Worker | 140 Michigan Ave W, Battle Creek, MI 49017-3602 | 2020-10-25 |
1649880758 | Theodore James Smith | Physical Therapist | 4605 Sawmill Rd, Upper Arlington, OH 43220-2246 | 2020-08-04 |
1336506658 | Theodore C Smith | Registered Nurse | 600 East Blvd, Elkhart, IN 46514-2483 | 2016-01-16 |
1841600947 | Theodore Roosevelt Smith IIi | Behavioral Analyst | 3171 S Jones Blvd, Las Vegas, NV 89146-6703 | 2014-04-29 |
Street Address |
1690 SKYLYN DR STE 210 |
City | SPARTANBURG |
State | SC |
Zip Code | 29307-1075 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700842333 | Matthew Jonathan Edwards | Family Medicine | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 | 2006-04-22 |
1174092449 | Spartanburg Medical Center | Family Medicine | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 | 2018-11-16 |
1275057770 | Brittany Earnhardt Saleeby | Nurse Practitioner | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307 | 2017-07-27 |
1760493985 | Mary Black Hlth Sys, LLC | Durable Medical Equipment & Medical Supplies | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 | 2006-08-11 |
1457366262 | Donna-marie Koroma | Family Medicine | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 | 2006-07-30 |
1477506673 | Henry G. Cupstid | Family Medicine | 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 | 2006-05-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
Find all providers in zip 29307 |
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 |
---|---|---|---|---|
1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
1538713813 | Proactive Md Sc,p.a. | Family Medicine | 101 W Saint John St Ste 107, Spartanburg, SC 29306-5157 | 2019-07-25 |
1073171336 | Proactive Md Sc,p.a. | Family Medicine | 801 Union St, Spartanburg, SC 29302-2734 | 2019-06-03 |
1841757192 | Paladina Health, LLC | Family Medicine | Paladina Health Smith Drug, 9098 Fairforest Road, Spartanburg, SC 29301 | 2019-02-22 |
1487111738 | Paladina Health, LLC | Family Medicine | Paladina Health Spartanburg Palmetto Bank, 101 West Saint John Street Suite 107, Spartanburg, SC 29306 | 2019-02-22 |
1649735127 | Spartanburg Medical Center | Family Medicine | 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 | 2019-02-08 |
1114403342 | Piedmont Care, Inc. | Family Medicine | 101 N Pine St Ste 200, Spartanburg, SC 29302-1604 | 2018-07-11 |
1356871933 | Kristy Kaye Atkinson | Family Medicine | 853 N Church St # 150, Spartanburg, SC 29303-3098 | 2017-06-15 |
1003352261 | Academic Primary Care Associates | Family Medicine | 410 Magnolia St, Spartanburg, SC 29303-3640 | 2017-01-12 |
Find all providers in SPARTANBURG |
City | SPARTANBURG |
Zip Code | 29307 |
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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.