JAY RANDALL ERICKSON (NPI# 1558363077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558363077 |
| Entity Type | Individual |
| Full Name | JAY RANDALL ERICKSON |
| Credential | MD |
| Practice Address |
1029 Edgefield St Greenwood SC 29646-3205 |
| Practice Telephone | 8643882122 |
| Practice Fax Number | 8643887948 |
| Mailing Telephone | 8643882122 |
| Mailing Fax Number | 8643887948 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
18669 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | T25381 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114990587 | Jay C. Erickson | Psychiatry & Neurology | 1608 S J St Fl 5, Tacoma, WA 98405-4930 | 2006-02-08 |
| 1447246152 | Jay Erickson | Family Medicine | 1458 4th St Mcagcc/ Magtftc, 7th Marine Regimental Aid Station, Twentynine Palms, CA 92278 | 2005-09-27 |
| 1033556105 | Jay M Erickson | Dentist | 1509 Emerald Pkwy Ste 105, College Station, TX 77845-5502 | 2013-05-30 |
| 1255517702 | Jay Emory Erickson | Counselor | 900 S Broadway, Suite 100, Denver, CO 80209-4198 | 2008-01-15 |
| 1083753032 | Jay Merwin Erickson | Chiropractor | 455 N Milledge Ave, Athens, GA 30601-3807 | 2007-02-06 |
| 1932283231 | Jay Roger Erickson | Internal Medicine | 1717 N E St, Suite 439, Pensacola, FL 32501-6339 | 2006-10-24 |
| 1992896864 | Jay T Erickson | Nurse Anesthetist, Certified Registered | 300 N 7th St, Bismarck, ND 58501-4439 | 2006-09-27 |
| 1235237660 | Jay S Erickson | Family Medicine | 1111 Baker Ave, Glacier Medical Associates, Whitefish, MT 59937-2901 | 2006-09-20 |
| Street Address |
1029 EDGEFIELD ST |
| City | GREENWOOD |
| State | SC |
| Zip Code | 29646-3205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063652717 | Leslie Mactaggart Myers | Nurse Practitioner | 1029 Edgefield St, Greenwood, SC 29646-3205 | 2009-02-20 |
| 1427040120 | Nancy B Joseph | Legal Medicine | 1029 Edgefield St, Greenwood, SC 29646-3205 | 2005-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535416 | Supriya Lal | Dietitian, Registered | 303 Parkwood Rd, Greenwood, SC 29646 | 2020-07-22 |
| 1174158406 | Mara L Schwartz | Registered Nurse | 1226 Spring St., Diabtes Education Department, Greenwood, SC 29646 | 2020-03-06 |
| 1487213724 | Greater Greenwood United Ministry | Family Medicine | 1404 Edgefield Street, Greenwood, SC 29646 | 2019-06-11 |
| 1346747995 | Kelli Diane Clune | Nurse Practitioner | 115 E Alexander Ave, Greenwood, SC 29646 | 2018-04-10 |
| 1184150112 | Sanquinette Sanders Brownlee | Nurse Practitioner | 929 Phoenix Stret, Clinica Gratis, Greenwood, SC 29646 | 2017-05-11 |
| 1194258426 | Kimberley Lovejoy | Assistant Behavior Analyst | 210a Birchtree, Greenwood, SC 29646 | 2017-04-04 |
| 1427590900 | Rejuvenation Massage By Frances | Clinic/Center | 610 Chace Avenue, Greenwood, SC 29646 | 2016-11-15 |
| 1932651643 | Hayley Smith | Counselor | 110 Court Ave W, Greenwood, SC 29646 | 2016-10-28 |
| 1942757927 | Towanda Morton | Community Health Worker | 303 Suite B South Main Street, Greenwood, SC 29646 | 2016-09-07 |
| 1770039976 | Bragan Mace | Pharmacist | 1376 South Main St., Greenwood, SC 29646 | 2016-08-28 |
| Find all providers in zip 29646 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336347319 | Greenwood Center for Gynecology, LLC | Obstetrics & Gynecology | 1029 A Edgefield St, Greenwood, SC 29646-3205 | 2007-07-11 |
| 1598847253 | Sr Evans Jr. | Obstetrics & Gynecology | 1604 Leflore Ave, Greenwood, MS 38930 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215598230 | Elite Gynecology | Obstetrics & Gynecology | 163 Lake Murray Ter, Lexington, SC 29072-9103 | 2019-06-21 |
| 1295392132 | Venus Gynecology, LLC | Obstetrics & Gynecology | 8203 Nigels Dr Ste 203, Myrtle Beach, SC 29572-4179 | 2019-05-28 |
| 1801285036 | Roper Saint Francis Physicians Network | Obstetrics & Gynecology | 8950 University Blvd, Suite 150, North Charleston, SC 29406 | 2015-01-12 |
| 1447656517 | Donald Richard Hanscom | Obstetrics & Gynecology | 20 Spring Island Dr, Okatie, SC 29909-4006 | 2014-11-17 |
| 1851633028 | Giles Martin Schanen I | Obstetrics & Gynecology | 205 Glen Abbey Way, Greer, SC 29650-3289 | 2013-03-26 |
| 1225373830 | Alan F Korhammer | Obstetrics & Gynecology | 24 Oak Island Rd, Saint Helena Island, SC 29920-3808 | 2012-12-07 |
| 1326316803 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 90 Summit Centre Dr, Columbia, SC 29229-6926 | 2011-12-12 |
| 1528290251 | Baptist Easley Hospital | Obstetrics & Gynecology | 112 John St Ste 103, Easley, SC 29640-1405 | 2009-08-13 |
| 1386880672 | Juliet Chhay Bishop | Obstetrics & Gynecology | 2 Medical Park Rd Ll9/10, Columbia, SC 29203-6839 | 2008-12-17 |
| 1073776118 | Eduardo Goquiolay Arellano | Obstetrics & Gynecology | 9 Bayley Rd, Bluffton, SC 29910-4928 | 2008-07-09 |
| Find all providers with the same taxonomy | ||||
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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.