DERRICK SWARTZENTRUBER (NPI# 1649666827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649666827 |
| Entity Type | Individual |
| Full Name | DERRICK SWARTZENTRUBER |
| Credential | M.D. |
| Practice Address |
701 Grove Rd Fl 1 Greenville SC 29605-4210 |
| Mailing Address |
100 Cuthbert Dr Goose Creek SC 29445-3309 |
| Practice Telephone | 8644557899 |
| Practice Fax Number | 8644555474 |
| Mailing Telephone | 8643789073 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2019-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
52284 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
701 GROVE RD FL 1 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720081987 | Christopher Ira Kauffman | Psychiatry & Neurology | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2005-05-23 |
| 1104464353 | David Stepanovich Yasabash | Nurse Practitioner | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-12-18 |
| 1932745874 | Daniel William Miller | Physician Assistant | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-11-26 |
| 1225672488 | Rebekah Christine Carrington | Emergency Medicine | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-10-31 |
| 1588211197 | Jacqueline Gabrielle Wiles | Nurse Practitioner | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-08-20 |
| 1720634702 | Lindsey Stevenson Coutu | Nurse Practitioner | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-08-14 |
| 1609429570 | David Svintsitski | Physician Assistant | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-07-19 |
| 1366008468 | Jennifer Baulieu Tefft | Physician Assistant | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-05-14 |
| 1891257234 | Ashley Michelle Lane | Registered Nurse | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-04-04 |
| 1932669900 | Donald Reed Stanton II | Nurse Practitioner | 701 Grove Rd Fl 1, Greenville, SC 29605-4210 | 2019-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427151083 | Matthew B Dewys | Emergency Medicine | 615 S Bower St, Greenville, MI 48838-2614 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164999744 | Joseph Simmons Jr. | Emergency Medicine | 3300 W Brewington Rd, Sumter, SC 29153-8336 | 2018-10-31 |
| 1053720417 | Ralph Mckeetha Shealy | Emergency Medicine | 2719 Coddell Ct, Mount Pleasant, SC 29466-7930 | 2014-08-10 |
| 1508158296 | Toni Nmi Manos | Emergency Medicine | 1742 E. Ashley Ave., Folly Beach, SC 29439-0049 | 2011-05-12 |
| 1104096619 | Steve W. Schwartz | Emergency Medicine | 671 Jamestown Dr Ste 203, Murrells Inlet, SC 29576-7507 | 2008-03-11 |
| 1629294798 | Clara Elisabeth Gulyas | Emergency Medicine | 202 Wall St, Piedmont, SC 29673-6754 | 2007-04-17 |
| 1598897951 | Stephen A Harvey | Emergency Medicine | 3655 Mitchell St # 690001, Loris, SC 29569-2827 | 2007-03-12 |
| 1285776674 | Cox Medical Response Inc | Emergency Medicine | 312 S Pine St, Marion, SC 29571 | 2007-02-13 |
| 1285706747 | Malcolm Keith Sale | Emergency Medicine | 20 Balmoral Pl, Hilton Head Island, SC 29926-2270 | 2006-11-13 |
| 1629169867 | James D Dunda | Emergency Medicine | 1011 Ella St, Anderson, SC 29621-4807 | 2006-09-27 |
| 1518068873 | Marva Denise Williams | Emergency Medicine | 107 Sunset Dr, Manning, SC 29102-2904 | 2006-09-26 |
| Find all providers with the same taxonomy | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.