STARFISH PEDIATRIC ENT, LLC (NPI# 1609491737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609491737 |
| Entity Type | Organization |
| Organization Name | STARFISH PEDIATRIC ENT, LLC |
| Practice Address |
110b Springhall Dr Goose Creek SC 29445-5335 |
| Practice Telephone | 8437380218 |
| Practice Fax Number | 8432074975 |
| Mailing Telephone | 8437380218 |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | GEORGE HARRIS (OWNER) |
| Authorized Official Telephone | 8437380218 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
Allopathic & Osteopathic Physicians |
| Street Address |
110B SPRINGHALL DR |
| City | GOOSE CREEK |
| State | SC |
| Zip Code | 29445-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164961249 | Ppcp Specialty Physicians, LLC | Psychiatry & Neurology | 110b Springhall Dr, Goose Creek, SC 29445-5335 | 2017-02-22 |
| 1366974644 | Palmetto Primary Care Physicians, LLC | Psychiatry & Neurology | 110b Springhall Dr, Goose Creek, SC 29445-5335 | 2017-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309953 | Auriel Mcconnell | Home Health | 616 One Mans Court, Mount Pleasant, SC 29445 | 2020-06-03 |
| 1215594023 | Tanova Cornise Robinson | Counselor | 96 Wisteria Road, Goose Creek, SC 29445 | 2019-05-28 |
| 1417421777 | Debra Liana Kerness | Social Worker | 100-a Central Avenue, Suite 203, Goose Creek, SC 29445 | 2019-01-18 |
| 1043663503 | Aimee Nehiley | Dentist | 615 Saint James Ave, Goose Creek, SC 29445 | 2016-07-20 |
| 1881057032 | Eddie Emanuel Nance | Family Medicine | 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC 29445 | 2016-04-04 |
| 1295195188 | Dental Professionals of South Carolina, PC | Dentist | 615 St. James Ave, Goose Creek, SC 29445 | 2016-03-04 |
| 1144603622 | Laryssa Smith | Pharmacist | 215 St. James Ave, Goose Creek, SC 29445 | 2015-07-02 |
| 1730439126 | O'stacia Williamson | Pharmacist | 1316 Redbank Rd, 9, Goose Creek, SC 29445 | 2012-09-13 |
| 1164771275 | Mary Ashley Watts | Pharmacist | 431 B St James Ave Suite I, Goose Creek, SC 29445 | 2012-09-05 |
| 1598048860 | Brianne Michele Terry | Pharmacist | 142 East Saint James Ave, Goose Creek, SC 29445 | 2011-09-23 |
| Find all providers in zip 29445 | ||||
| Taxonomy Code | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053474163 | Edward Benjamin Penn Jr. | Otolaryngology | 200 Patewood Dr Ste B400, Greenville, SC 29615-6306 | 2006-12-19 |
| 1396189486 | Phayvanh Pecha | Otolaryngology | 171 Ashley Ave, Charleston, SC 29425 | 2013-04-19 |
| 1962638502 | Clarice Seifert Clemmens | Otolaryngology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2009-06-10 |
| 1134153083 | South Carolina Ent Allergy & Sleep Medicine Pa | Otolaryngology | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2006-07-10 |
| 1447293121 | David Macy Vidrine | Otolaryngology | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2006-06-13 |
| City | GOOSE CREEK |
| Zip Code | 29445 |
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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.