EASLEY M R I L L C (NPI# 1508836974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508836974 |
| Entity Type | Organization |
| Organization Name | EASLEY M R I L L C |
| Other Organization Name | EASLEY MRI |
| Practice Address |
200 Fleetwood Dr Suite 100 Easley SC 29640-2022 |
| Mailing Address |
Po Box 3088 Greenville SC 29602-3088 |
| Practice Telephone | 8645527470 |
| Practice Fax Number | 8645527471 |
| Mailing Telephone | 8645527470 |
| Mailing Fax Number | 8645527471 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2008-05-09 |
| Authorized Official Name | DR. CHARLES DAVID WILLIAMS III (PRESIDENT) |
| Authorized Official Telephone | 8642954410 |
| Authorized Official Credential | M D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RAILROAD MEDICARE | CJ7945 | 01 |
| SC | SL0051 | 05 |
| Other Name | Type Code |
|---|---|
| Easley MRI | Other Name - Individual/Organization |
| Street Address |
200 FLEETWOOD DR SUITE 100 |
| City | EASLEY |
| State | SC |
| Zip Code | 29640-2022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306914 | Connie Burth | Pharmacist | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2020-11-05 |
| 1609476985 | Pamela Page Polk | Pharmacist | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2020-10-27 |
| 1134728140 | Rhett Powell | Pharmacist | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2020-10-21 |
| 1063044600 | Jacquelyn Nicole Greene | Internal Medicine | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2020-02-11 |
| 1538635057 | Kathryn Lybrand | Dietitian, Registered | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2018-10-23 |
| 1639656713 | Prisma Health-upstate | General Acute Care Hospital | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2018-07-23 |
| 1376053298 | Lynn Kelsey Kline | Dietitian, Registered | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2017-10-05 |
| 1194254318 | Dorothy Warren Shovlin | Nurse Practitioner | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2017-06-10 |
| 1154859031 | Baptist Easley | Family Medicine | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2017-05-23 |
| 1245767482 | Baptist Easley Hospital | Family Medicine | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2017-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063935773 | Mary Kathryn Henderson | Speech-Language Pathologist | 1400 Griffin Mill Road, Easley, SC 29640 | 2017-07-25 |
| 1417309451 | Ashby Park Pediatric Dentistry Easley | Dentist | 708 North A Street, Easley, SC 29640 | 2016-07-01 |
| 1548696990 | Phuong T Tran | Pharmacist | 309 Rolling Hills Circle, Easley, SC 29640 | 2013-09-17 |
| 1538593017 | Baptist Easley Hospital | Clinic/Center | 200 Fleet Wood Dr 3 Rd Floor, Easley, SC 29640 | 2013-09-03 |
| 1942507173 | Joanne Mason Wilkinson | Occupational Therapist | 1807a East Main St, Easley, SC 29640 | 2011-02-24 |
| 1861793911 | Ark Pharmacy Services LLC | Pharmacy | 5119- A Calhoun Memorial Hwy, Easley, SC 29640 | 2010-11-05 |
| 1659507952 | Sarah Elizabeth Proulx | Dentist | 227 South Pendleton Street, Suita A, Easley, SC 29640 | 2009-06-02 |
| 1508030503 | Jean Claire Palmour | Massage Therapist | 404 South Fifth Street, Jj & Company Salon & Spa, Easley, SC 29640 | 2008-04-22 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1942419171 | William Kent Hammond | Dentist | 298 Enterprise Dr, Easley, SC 29640 | 2007-05-22 |
| Find all providers in zip 29640 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486786 | Tara Noone | Radiology | 545 Planters Loop, Mount Pleasant, SC 29464-2743 | 2020-08-04 |
| 1447728795 | Island Imaging, LLC | Radiology | 40 Palmetto Parkway, Hilton Head Island, SC 29926 | 2018-11-05 |
| 1417423088 | Bon Secours Diagnostic Imaging | Radiology | 1 Marcus Dr Ste 100, Greenville, SC 29615-4818 | 2018-10-22 |
| 1700352374 | Bon Secours Diagnostic Imaging | Radiology | 2 Innovation Dr Ste 350, Greenville, SC 29607-5269 | 2018-10-22 |
| 1548797533 | Gregory S Connor, Md, Pa | Radiology | 628 W Home Ave, Hartsville, SC 29550-4430 | 2017-05-22 |
| 1407393861 | Mcleod Physician Associates II | Radiology | 1116 W Evans St, Florence, SC 29501-3320 | 2017-01-24 |
| 1932651908 | Long Bay Diagnostic Imaging Murrells Inlet, LLC | Radiology | 4407 Highway 17 Bypass, Murrells Inlet, SC 29576-5097 | 2016-10-26 |
| 1245687540 | John Frederick Hughes | Radiology | 96 Jonathan Lucas St # 323, Charleston, SC 29425-3230 | 2016-05-17 |
| 1295104073 | Arthur Knight Walter | Radiology | 737 River Rd, Columbia, SC 29212-8809 | 2015-09-22 |
| 1386030021 | Shawn Hobby | Radiology | 96 Jonathan Lucas St Charleston Sc 29425, Charleston, SC 29425-0001 | 2015-04-09 |
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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.