THE PEDIATRIC CENTER (NPI# 1558415844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558415844 |
| Entity Type | Organization |
| Organization Name | THE PEDIATRIC CENTER |
| Practice Address |
111 Memorial Dr Greer SC 29650-1518 |
| Practice Telephone | 8648487004 |
| Practice Fax Number | 8648483666 |
| Mailing Telephone | 8648487004 |
| Mailing Fax Number | 8648483666 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. AZIZ GHANDNOOSH (PHYSICIAN) |
| Authorized Official Telephone | 8648487005 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 18570 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | T26745 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477822690 | The Pediatric Center | Nurse Practitioner | 126 Morgan Street, Stamford, CT 09605 | 2011-12-16 |
| 1356431274 | The Pediatric Center | Pediatrics | 2050 Mariner Dr, Suite #150, Las Vegas, NV 89128-6656 | 2006-10-13 |
| 1528003365 | The Pediatric Center | Pediatrics | 1447 Medical Park Blvd., Suite 402, Wellington, FL 33414 | 2006-06-17 |
| 1902091572 | The Pediatric Center | Pediatrics | 967 Bellefontaine Ave, Lima, OH 45804-2888 | 2007-09-07 |
| 1659485415 | The Pediatric Center | Clinic/Center | 1914 Glen Meade Rd, Wilmington, NC 28403-6025 | 2006-08-18 |
| Street Address |
111 MEMORIAL DR |
| City | GREER |
| State | SC |
| Zip Code | 29650-1518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245227438 | Hajar Raissi-fard | Pediatrics | 111 Memorial Dr, Pediatric Center, Greer, SC 29650-1518 | 2005-10-03 |
| 1437146628 | Aziz Ghondnoosh | Pediatrics | 111 Memorial Dr, Pediatric Center, Greer, SC 29650-1518 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154946424 | Paul Wong | Family Medicine | 109 Physicians Drive Suite A, Greer, SC 29650 | 2020-06-12 |
| 1992273684 | Christopher Michael Campbell | Pharmacist | 845b S Buncombe Rd, Greer, SC 29650 | 2018-11-12 |
| 1376035618 | Jessica Miller | Dentist | 1494 W Wade Hampton Blvd Ste D, Greer, SC 29650 | 2018-06-02 |
| 1992212872 | Greenville Health Corporation | Pharmacy | 845 S Buncombe Rd Ste D, Greer, SC 29650 | 2018-01-02 |
| 1114432077 | Spartanburg Medical Center | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200m, Greer, SC 29650 | 2017-12-13 |
| 1437679750 | Sanders Healthcare LLC | Home Health | 110 W. Church St., Suite A, Greer, SC 29650 | 2017-06-27 |
| 1306291117 | James Elliott Crouch | Occupational Therapy Assistant | 1305 Boilings Springs Rd., Greer, SC 29650 | 2016-04-29 |
| 1033593389 | Premier Medical Transport Service | Non-emergency Medical Transport (VAN) | 120 Glenaire Dr, Greer, SC 29650 | 2015-07-16 |
| 1104176429 | Suchi Chomal | Pharmacist | 6 Colby Ct, Greer, SC 29650 | 2012-09-13 |
| 1447500822 | John Varner | Pharmacist | 821 S. Batesville Road, Greer, SC 29650 | 2012-09-13 |
| Find all providers in zip 29650 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083077184 | Bradley Sieckman | Pediatrics | 106 Physicans Drive, Greer, SC 29650-1521 | 2016-04-05 |
| 1588924526 | William Jeffrey Broome | Pediatrics | 145 E Poinsett St, Greer, SC 29651-3405 | 2012-05-24 |
| 1467605774 | James Harold Sightler | Pediatrics | 175 Joe Leonard Road, Greer, SC 29651-9056 | 2008-10-30 |
| 1538172960 | Mark A Demoss | Pediatrics | 501c Memorial Dr Ext, Greer, SC 29651 | 2006-08-15 |
| 1285694596 | James Raff | Pediatrics | 319 S Buncombe Rd, Greer, SC 29650-1207 | 2006-03-23 |
| 1538130331 | Jeffrey Neal Faust | Pediatrics | 318 Memorial Dr, Greer, SC 29650-1521 | 2006-01-30 |
| 1245227438 | Hajar Raissi-fard | Pediatrics | 111 Memorial Dr, Pediatric Center, Greer, SC 29650-1518 | 2005-10-03 |
| 1508253204 | Melody Miller | Pediatrics | 318 Memorial Dr, Greer, SC 29650 | 2015-04-20 |
| 1952515603 | Susan Catherine Shelley | Pediatrics | 318 Memorial Dr, Greer, SC 29650-1521 | 2007-05-10 |
| 1184735409 | Michelle Rene Viglianco-vanpelt | Pediatrics | 325 Medical Pkwy, Suite 150, Greer, SC 29650-2457 | 2006-08-31 |
| Find all providers in GREER | ||||
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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.