MICHAEL KEASLER WELBORN (NPI# 1639120439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639120439 |
| Entity Type | Individual |
| Full Name | MICHAEL KEASLER WELBORN |
| Credential | MD |
| Practice Address |
115 Brushy Creek Rd Easley SC 29642-1120 |
| Mailing Address |
Po Box 1315 Easley SC 29641-1315 |
| Practice Telephone | 8646350376 |
| Practice Fax Number | 8644426848 |
| Mailing Telephone | 8646350376 |
| Mailing Fax Number | 8644426848 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5415 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 054158 | 05 | |
| SC | BLUE CROSS | 582296052-055 | 01 |
| Street Address |
115 BRUSHY CREEK RD |
| City | EASLEY |
| State | SC |
| Zip Code | 29642-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992793780 | Mark James Wasylenko | Specialist | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2005-10-06 |
| 1700404019 | Katherine Joy Hendricks | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2020-07-13 |
| 1467091306 | Carolina Spine and Pain Centers, LLC | Clinic/Center | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2019-12-23 |
| 1821637760 | Csp Enterprises LLC | Anesthesiology | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2019-12-23 |
| 1205387883 | Melody Young Deangelis | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2016-10-19 |
| 1588047732 | Joseph A Pilgrim | Physical Therapist | 115 Brushy Creek Rd, Suite A, Easley, SC 29642-1120 | 2015-07-07 |
| 1538573431 | Jessica Gravely Bell | Nurse Practitioner | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2014-06-18 |
| 1215348644 | Exigo Pharmaceuticals, LLC | Pharmacy | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2014-05-20 |
| 1811318512 | Oaktree Medical Centre | Physical Medicine & Rehabilitation | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2013-12-23 |
| 1386925758 | Jonathan David Haas | Physical Therapist | 115 Brushy Creek Rd, Advanced Physical Therapy, Easley, SC 29642-1120 | 2011-08-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1437648904 | Onsite Healthcare and Wellness LLC | Nurse Practitioner | 217 Sheffield Ct, Easley, SC 29642 | 2018-05-09 |
| 1477073476 | Aubre True | Specialist/Technologist | 124 Century Oaks Dr, Easley, SC 29642 | 2017-06-21 |
| 1912439944 | First Physical Therapy, LLC | Clinic/Center | 3613 Sc 153, Suite 200, Powdersville, SC 29642 | 2017-03-29 |
| 1801146485 | Sara Michele Calvert | Pharmacist | 1063 South Pendleton Street, Easley, SC 29642 | 2012-09-11 |
| 1023365251 | Heather Lilley | Pharmacist | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2012-08-07 |
| 1942590088 | Mallorie Bryan Costner | Speech-Language Pathologist | 507 Huntington Road, Easley, SC 29642 | 2011-04-11 |
| 1225352339 | Jon Lawrence Rhoden | Pharmacist | 320 Watson Road, Easley, SC 29642 | 2010-03-18 |
| 1386865350 | Gordon David Dannelly | Dentist | 701 Brushy Creek Road, Easley, SC 29642 | 2007-05-01 |
| 1538280755 | Michelle Leigh Tucker | Obstetrics & Gynecology | 1351 Crestview Road, Easley, SC 29642 | 2007-04-03 |
| Find all providers in zip 29642 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770787426 | Myra Aurelia Phipps | Family Medicine | 303 Dacusville Hwy, Easley, SC 29640-1510 | 2007-06-14 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1265645352 | Palmetto Health | Family Medicine | 104 Fleetwood Drive, Easley, SC 29640 | 2007-05-07 |
| 1821018391 | Anne-marie Catherine Leventis | Family Medicine | 202 Buckingham Rd, Easley, SC 29640-1358 | 2006-07-20 |
| 1609895523 | Marian Barton Clinch | Family Medicine | 300 Fleetwood Drive, Easley, SC 29640 | 2006-07-19 |
| 1235174848 | Palmetto Health | Family Medicine | 201 W A Ave, Easley, SC 29640-2051 | 2006-06-18 |
| 1790737369 | Palmetto Health | Family Medicine | 106 John St, Suite B, Easley, SC 29640-1415 | 2006-05-16 |
| 1811948896 | Palmetto Health | Family Medicine | 104 Fleetwood Dr, Easley, SC 29640-2020 | 2006-05-13 |
| 1033173778 | Patrick G Lollis | Family Medicine | 700 Brushy Creek Rd, Easley, SC 29642-2200 | 2006-04-12 |
| 1558364109 | Ben William Wilson Jr. | Family Medicine | 10701 Anderson Rd, Easley, SC 29642-9309 | 2005-05-27 |
| Find all providers in EASLEY | ||||
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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.