RADIANT NEUROMONITORING LLC (NPI# 1750811089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750811089 |
| Entity Type | Organization |
| Organization Name | RADIANT NEUROMONITORING LLC |
| Practice Address |
101 Lawson Dr # 104 Charleston SC 29404-2121 |
| Practice Telephone | 8542028292 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2017-11-20 |
| Authorized Official Name | TIMOTHY DELONG (NPI REPRESENTATIVE) |
| Authorized Official Telephone | 2105982800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians |
| Street Address |
101 LAWSON DR # 104 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29404-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346751971 | James Tyrone Wilder | Social Worker | B, 1001 Michigan Ave, Joint Base, Charleston, SC 29404 | 2017-10-23 |
| 1033422902 | Michael Ryan Moore | Physical Therapist | 628th Medical Group, 204 West Hill Blvd, Charleston, SC 29404 | 2010-07-21 |
| 1720221013 | Cristy Jo Preslar | Military Health Care Provider | 364 Arthur Drive, Charleston Afb, SC 29404 | 2009-04-16 |
| 1336237627 | Douglas Vail Campbell | Psychologist | 437mdos/lssc - 204 West Hill Blvd, Charleston Afb, SC 29404 | 2006-10-11 |
| 1124019914 | Neal Robert Taylor | Family Medicine | 628 Medical Group 204 W. Hill Blvd, Jb Charleston, SC 29404 | 2005-11-02 |
| 1063852978 | Chantell Renee Mckee | Family Medicine | 204 W Hill Blvd, Charleston Afb, SC 29404 | 2013-06-25 |
| 1487665972 | Joseph Russell Maiden Sr. | Social Worker | 204 W Hill Blvd, 437 Medical Operations Squadron, Charleston, SC 29404 | 2006-08-10 |
| 1295092328 | Suzanne M O'shea | Registered Nurse | 204 W. Hill Blvd, Charleston, SC 29404-0000 | 2012-04-13 |
| 1306281373 | Michelle Karen Calandra | Registered Nurse | 1000 Michigan Ave, Charleston Afb, SC 29404-2020 | 2013-05-06 |
| 1336560440 | Merin Williams | Speech-Language Pathologist | 1000 Michigan Ave, Charleston Afb, SC 29404-2020 | 2013-12-17 |
| Find all providers in zip 29404 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740474329 | Samina Kazmi Md Pllc | Psychiatry & Neurology | 415 Morris St Ste 403, Charleston, WV 25301-1854 | 2007-08-28 |
| 1518371277 | Laura Juul | Psychiatry & Neurology | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425-8905 | 2014-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770084063 | Neuroshield Network Se LLC | Psychiatry & Neurology | 1304 Sunset Blvd, West Columbia, SC 29169-5914 | 2018-02-22 |
| 1972845766 | Matthew Jedediah Schrettner | Psychiatry & Neurology | 200 Patewood Dr Ste B350, Greenville, SC 29615 | 2013-03-20 |
| 1023088002 | Meng Zhou-wang | Psychiatry & Neurology | 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 | 2006-01-24 |
| City | CHARLESTON |
| Zip Code | 29404 |
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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.