CAROLINA SPINE AND PAIN CENTERS, LLC (NPI# 1467091306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467091306 |
| Entity Type | Organization |
| Organization Name | CAROLINA SPINE AND PAIN CENTERS, LLC |
| Practice Address |
115 Brushy Creek Rd Easley SC 29642-1120 |
| Practice Telephone | 8646350376 |
| Practice Fax Number | 8644426848 |
| Mailing Telephone | 8646350376 |
| Mailing Fax Number | 8644426848 |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2020-04-10 |
| Authorized Official Name | BLAKE LECHE (MEMBER) |
| Authorized Official Telephone | 8646350376 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 314305 | 05 |
| Street Address |
115 BRUSHY CREEK RD |
| City | EASLEY |
| State | SC |
| Zip Code | 29642-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992793780 | Mark James Wasylenko | Specialist | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2005-10-06 |
| 1700404019 | Katherine Joy Hendricks | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2020-07-13 |
| 1821637760 | Csp Enterprises LLC | Anesthesiology | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2019-12-23 |
| 1205387883 | Melody Young Deangelis | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2016-10-19 |
| 1588047732 | Joseph A Pilgrim | Physical Therapist | 115 Brushy Creek Rd, Suite A, Easley, SC 29642-1120 | 2015-07-07 |
| 1538573431 | Jessica Gravely Bell | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2014-06-18 |
| 1215348644 | Exigo Pharmaceuticals, LLC | Pharmacy | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2014-05-20 |
| 1811318512 | Oaktree Medical Centre | Physical Medicine & Rehabilitation | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2013-12-23 |
| 1386925758 | Jonathan David Haas | Physical Therapist | 115 Brushy Creek Rd, Advanced Physical Therapy, Easley, SC 29642-1120 | 2011-08-30 |
| 1487984951 | Advanced Physical Therapy,llc | Clinic/Center | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2010-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1437648904 | Onsite Healthcare and Wellness LLC | Nurse Practitioner | 217 Sheffield Ct, Easley, SC 29642 | 2018-05-09 |
| 1477073476 | Aubre True | Specialist/Technologist | 124 Century Oaks Dr, Easley, SC 29642 | 2017-06-21 |
| 1912439944 | First Physical Therapy, LLC | Clinic/Center | 3613 Sc 153, Suite 200, Powdersville, SC 29642 | 2017-03-29 |
| 1801146485 | Sara Michele Calvert | Pharmacist | 1063 South Pendleton Street, Easley, SC 29642 | 2012-09-11 |
| 1023365251 | Heather Lilley | Pharmacist | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2012-08-07 |
| 1942590088 | Mallorie Bryan Costner | Speech-Language Pathologist | 507 Huntington Road, Easley, SC 29642 | 2011-04-11 |
| 1225352339 | Jon Lawrence Rhoden | Pharmacist | 320 Watson Road, Easley, SC 29642 | 2010-03-18 |
| 1386865350 | Gordon David Dannelly | Dentist | 701 Brushy Creek Road, Easley, SC 29642 | 2007-05-01 |
| 1538280755 | Michelle Leigh Tucker | Obstetrics & Gynecology | 1351 Crestview Road, Easley, SC 29642 | 2007-04-03 |
| Find all providers in zip 29642 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497886329 | Palmetto Health Baptist Easley | Clinic/Center | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551926 | Nocd North Carolina PC | Clinic/Center | 374 Lakewind Dr, Moncks Corner, SC 29461-7448 | 2020-03-02 |
| 1316419484 | Open Arms Counseling Center | Clinic/Center | 123 Erinvine Ct, Darlington, SC 29532-4203 | 2018-12-29 |
| 1750851085 | Jacobus Orthopedics and Interventional Pain Management LLC | Clinic/Center | 118 Clair Dr, Piedmont, SC 29673-7771 | 2018-11-29 |
| 1629556477 | Healthworks Med Group of South Carolina P C | Clinic/Center | 701 Chesterfield Hwy, Cheraw, SC 29520-7002 | 2018-08-03 |
| 1780177576 | Denmark-olar Elementary School | Clinic/Center | 1459 Solomon Blatt Blvd, Denmark, SC 29042 | 2018-06-07 |
| 1841782802 | Denmark-olar High School | Clinic/Center | 197 Viking Cir, Denmark, SC 29042 | 2018-06-05 |
| 1760974828 | Sandy Run K-8 School | Clinic/Center | 450 Old Swamp Rd, Swansea, SC 29160 | 2018-06-05 |
| 1881185999 | St. Matthews K-8 School | Clinic/Center | 132 Saints Avenue, St .matthews, SC 29135 | 2018-05-24 |
| 1598256711 | Calhoun County High School | Clinic/Center | 150 Saints Ave, St Matthews, SC 29135-9005 | 2018-05-23 |
| 1962908558 | Vitality Health Network LLC | Clinic/Center | 3100 Dick Pond Rd Unit E, Myrtle Beach, SC 29588-7286 | 2018-04-03 |
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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.