RODNEY OWEN LEACOCK (NPI# 1356436703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356436703 |
| Entity Type | Individual |
| Full Name | RODNEY OWEN LEACOCK |
| Credential | M.D. |
| Practice Address |
3 Richland Medical Park Dr Ste 310 Columbia SC 29203-6862 |
| Mailing Address |
Po Box 743904 Atlanta GA 30374-3904 |
| Practice Telephone | 8034348323 |
| Practice Fax Number | 8032968326 |
| Mailing Telephone | 8032967320 |
| Mailing Fax Number | 8032967330 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
200300373 | NC | Allopathic & Osteopathic Physicians |
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
35018 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89134XV | 05 | |
| SC | Q73003 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Patewood Dr, Suite B350, Greenville, SC 296153593 | 8644544500 | 8644544505 |
| 300 Palmetto Health Pkwy, Columbia, SC 292121761 | 8032967846 |
| Street Address |
3 RICHLAND MEDICAL PARK DR STE 310 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-6862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760584981 | Coleman S Fravel | Physician Assistant | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203 | 2006-09-01 |
| 1477194306 | Kelsey Fearing | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2019-10-02 |
| 1992362545 | Ivery Bonita Reed | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2019-05-20 |
| 1790349330 | Chandler Tyler | Physician Assistant | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2019-04-29 |
| 1770040776 | Tanisha Leann Dawkins | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2019-02-26 |
| 1013490911 | Tanyatta Lane King | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2018-09-07 |
| 1073095683 | Kimberly Sue Bregenzer | Neurological Surgery | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2018-08-30 |
| 1952899627 | Palmetto Health - University of South Carolina Medical Group | Neurological Surgery | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2018-04-27 |
| 1255836995 | Anita Dixon | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2018-03-26 |
| 1184140543 | Ansleigh Claire Morrow | Nurse Practitioner | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203 | 2017-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275973661 | Naresh Mullaguri | Psychiatry & Neurology | 200 Patewood Dr Ste B350, Greenville, SC 29615-6337 | 2013-06-28 |
| 1750724142 | Forrest Justin Lowe | Psychiatry & Neurology | 171 Ashley Ave, Charleston, SC 29425 | 2013-04-16 |
| 1619230240 | Varun Prafull Chaubal | Psychiatry & Neurology | 200 Patewood Dr Ste B350, Greenville, SC 29615-6337 | 2012-06-19 |
| 1942464961 | Mahmoud Rayes | Psychiatry & Neurology | 200 Patewood Dr, Ste B350, Greenville, SC 29615-3593 | 2008-07-18 |
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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.