DR. RICHARD SIDDALL PENNEBAKER (NPI# 1356399604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356399604 |
| Entity Type | Individual |
| Full Name | DR. RICHARD SIDDALL PENNEBAKER |
| Credential | M.D. |
| Practice Address |
57 Cross Park Court Greenville SC 29605-4264 |
| Mailing Address |
One Independence Pointe Suite 212 Greenville SC 29615-4566 |
| Practice Telephone | 8647976044 |
| Practice Fax Number | 8647976198 |
| Mailing Telephone | 8647976044 |
| Mailing Fax Number | 8647976198 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 12799 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | TL5018 | 05 |
| Street Address |
57 CROSS PARK COURT |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609380278 | Sarah Rider Grubbs | Pediatrics | 58 Park Vista Way, Greenville, SC 29617-7939 | 2017-11-18 |
| 1679005409 | Shailesh Manandhar | Pediatrics | 2816 Holly Glen Dr Apt A, Greenville, NC 27834-0064 | 2017-03-30 |
| 1114377645 | Madison Leigh Merritt | Pediatrics | 415 Duncan Chapel Rd, Greenville, SC 29617-8224 | 2016-06-15 |
| 1699139089 | Hunter Utkov Altman | Pediatrics | 701 Grove Road/ob Residency, Greenville, SC 29605-4210 | 2016-04-11 |
| 1851771976 | Ranjith Kasanagottu | Pediatrics | 200 Patewood Dr # A, Greenville, SC 29615-3593 | 2015-06-03 |
| 1336551365 | Sarah Rose Mangum Needham | Pediatrics | 709 Chesapeake Pl, Greenville, NC 27858-6236 | 2014-05-26 |
| 1124466164 | Katherine Marie Richardson | Pediatrics | 200 Patewood Drive Suite A200, Greenville, SC 29615-3580 | 2013-06-12 |
| 1689916264 | Shannon Nicole James | Pediatrics | 703 Verdae Blvd, Greenville, SC 29607 | 2013-03-21 |
| 1346411592 | Smithfield Pediatrics | Pediatrics | 7 Smith Avenue, Suite 103, Greenville, RI 02828 | 2008-03-16 |
| 1558546366 | Childrens Community Care | Pediatrics | 90 Shenango St Ste 12, Greenville, PA 16125-2060 | 2007-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.