DR. JEFFREY CLARK GERSBACH (NPI# 1548274343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548274343 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY CLARK GERSBACH |
| Credential | M.D. |
| Practice Address |
2645 Burden Creek Rd Johns Island SC 29455-4604 |
| Practice Telephone | 8432240880 |
| Practice Fax Number | 4259448954 |
| Mailing Telephone | 8435591958 |
| Mailing Fax Number | 8432257749 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2014-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 021585 | SC | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 14843 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PRIVATE INSURANCE | 010653103 | 01 |
| SC | BCBS | 010653103003 | 01 |
| SC | 148432 GP4105 | 05 |
| Street Address |
2645 BURDEN CREEK RD |
| City | JOHNS ISLAND |
| State | SC |
| Zip Code | 29455-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689216863 | Live for Wellness Johns Island | Chiropractor | 1803 Crowne Commons Way, Suite 1-a, Johns Island, SC 29455 | 2019-10-09 |
| 1588180186 | Ashley Nicole Cox | Specialist/Technologist | 24 Surfsong Rd, Johns Island, SC 29455 | 2017-08-16 |
| 1568820173 | Bernard Mansheim | Internal Medicine | 3226 Maybank Highway Ste 1a, Johns Island, SC 29455 | 2016-02-10 |
| 1932527843 | Gordon Theodore Davis | General Practice | 3226 Maybank Highway Suite 1-a, Barrier Islands Free Medical Clinics, Johns Island, SC 29455 | 2014-03-29 |
| 1568749596 | Dawn Lachelle Sykes | Chiropractor | 3029 Maybank Highway, Suite 1, Johns Island, SC 29455 | 2011-11-04 |
| 1265765994 | Raymond David Mulligan | Psychologist | 431 Snowy Egret Lane, Kiawah Island, SC 29455 | 2009-09-14 |
| 1912172636 | Nicole Marie Juntz | Chiropractor | 3069 Maybank Hwy, Johns Island, SC 29455 | 2008-04-23 |
| 1972701803 | Village Optical LLC | Optometrist | 634 Freshfields Drive, Johns Island, SC 29455 | 2007-07-03 |
| 1902982945 | John Patrick Howard | Dentist | 1684 Brownswood Rd., Our Lady of Mercy Outreach, Johns Island, SC 29455 | 2006-10-31 |
| 1265515795 | Vincents Drug Store and Soda Fountain | Pharmacy | 110 Planted Row Lane, Johns Island, SC 29455 | 2006-10-20 |
| Find all providers in zip 29455 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628898 | Gary L. Rose | Emergency Medicine | 1755 Ashley Hall Rd Apt E2, Charleston, SC 29407-3815 | 2020-08-05 |
| 1528690377 | Novant Health, Inc. | Emergency Medicine | 1423 Red Ventures Dr, Fort Mill, SC 29707-5019 | 2020-02-10 |
| 1912541814 | Colonial Family Practice, LLC | Emergency Medicine | 327 Broad St, Sumter, SC 29150-4152 | 2019-11-04 |
| 1962061747 | Nathan Barr | Emergency Medicine | Musc Emergency Department 171 Ashley Ave, Charleston, SC 29425-0001 | 2019-06-06 |
| 1942867767 | Robert Lee Stanley | Emergency Medicine | Emergency Medicine Dept, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-05-28 |
| 1790349355 | Romie Sarand Barnes | Emergency Medicine | Emergency Medicine Administration, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-04-29 |
| 1801350871 | Doctors Care, P.a. | Emergency Medicine | 12015 Highway 707, Murrells Inlet, SC 29576 | 2019-01-24 |
| 1457825846 | Aiken Professional Association LLC | Emergency Medicine | 110 Sasanqua Drive, Graniteville, SC 29829-4136 | 2019-01-18 |
| 1104393214 | David Weitzman Md PC | Emergency Medicine | 2423 Highway 17 S, North Myrtle Beach, SC 29582-4343 | 2018-10-26 |
| 1629561089 | John Brenton Bushkar | Emergency Medicine | 169 Ashley Ave Rm Nt265, Charleston, SC 29425 | 2018-06-11 |
| Find all providers with the same taxonomy | ||||
| City | JOHNS ISLAND |
| Zip Code | 29455 |
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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.