CHARLES KENNETH EDSALL I (NPI# 1841483344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841483344 |
| Entity Type | Individual |
| Full Name | CHARLES KENNETH EDSALL I |
| Credential | M. D. |
| Practice Address |
386 College Ave Clemson SC 29631-1432 |
| Mailing Address |
Po Box 100174 Columbia SC 29202-3174 |
| Practice Telephone | 8646542067 |
| Practice Fax Number | 8646535926 |
| Mailing Telephone | 8647166140 |
| Mailing Fax Number | 8647166149 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 29929 | SC | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
29929 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NPI | 1841483344 | 01 |
| SC | 299297 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Healthy Way Ste 1200, Anderson, SC 29621 | 8647166140 | 8647166159 |
| Street Address |
386 COLLEGE AVE |
| City | CLEMSON |
| State | SC |
| Zip Code | 29631-1432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225085699 | Theodore Swann | Family Medicine | 386 College Ave, Clemson, SC 29631-1475 | 2006-05-30 |
| 1568726495 | Jocelyn B Sikes | Nurse Practitioner | 386 College Ave, Clemson, SC 29631-1432 | 2012-06-26 |
| 1447473715 | Anmed Health Ob-gyn Associates | Obstetrics & Gynecology | 386 College Ave, Clemson, SC 29631-1432 | 2007-04-11 |
| 1083704175 | Robert Glen Quattlebaum | Family Medicine | 386 College Ave, Clemson, SC 29631-1432 | 2006-10-13 |
| 1346281912 | William Dukes Jr. | Family Medicine | 386 College Ave, Clemson, SC 29631 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059038 | James Ryan Small | Specialist/Technologist | 212 Vista Cir, Clemson, SC 29631 | 2019-12-09 |
| 1811559883 | Cheyenne Leigh Reynolds | Specialist/Technologist | 100 Reeves Way, Clemson, SC 29631 | 2019-07-01 |
| 1912474792 | Andrea Bagley Stokes | Physical Therapist | 500-1 Old Greenville Hwy # 1, Clemson, SC 29631 | 2018-10-30 |
| 1114426178 | Intouch Pharmacy LLC | Pharmacy | 105 Wall Street, Suite 10b, Clemson, SC 29631 | 2018-02-06 |
| 1881117695 | Community Pharmacy Group, Inc. | Pharmacy | 143 Thomas Green Blvd, Clemson, SC 29631 | 2017-07-24 |
| 1295286276 | James Matthew Mills | Occupational Therapist | 101 Chapman Rd, Clemson, SC 29631 | 2016-10-14 |
| 1558769141 | Virginia Bridges Gaulin | Counselor | 209 Pendleton Rd Ste C, Clemson, SC 29631 | 2014-12-12 |
| 1437580628 | Amanda Martin Eubanks | Speech-Language Pathologist | 101 Chapman Road Suite 202, Clemson, SC 29631 | 2013-12-12 |
| 1437408499 | Fort Hill Family Dentistry, Pa | Clinic/Center | 124 Strode Circle, Clemson, SC 29631 | 2012-09-06 |
| 1942511738 | Theresa S Ritter | Counselor | 386 College Avenue, Suite A, Clemson, SC 29631 | 2010-06-25 |
| Find all providers in zip 29631 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932369030 | Guillaume David Dumont | Orthopaedic Surgery | 2 Medical Park Road, Suite 104, Columbia, SC 29203-6875 | 2008-06-11 |
| 1922111715 | South Carolina Sports Medicine & Orthopaedic Center | Orthopaedic Surgery | 9100 Medcom Street, N Charleston, SC 29406 | 2006-08-16 |
| 1578570107 | Seth P Kupferman | Orthopaedic Surgery | 9100 Medcom St, N Charleston, SC 29406 | 2006-08-03 |
| 1720096357 | Gary E Windler | Orthopaedic Surgery | 9100 Medicom St, N Charleston, SC 29406 | 2006-08-03 |
| 1013965789 | Southern Orthopaedic Sports Medicne | Orthopaedic Surgery | 1718 Saint Julian Pl, Columbia, SC 29204-2410 | 2006-05-05 |
| 1427011485 | Thomas A. Leong | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200l, Greer, SC 29650-4902 | 2006-04-10 |
| 1770552481 | Bright Mcconnell IIi | Orthopaedic Surgery | 900 Island Park Dr, Suite 105, Daniel Island, SC 29492-7559 | 2006-03-15 |
| 1730162058 | David R Kingery | Orthopaedic Surgery | 811 W Main St Ste 101, Lexington, SC 29072-2500 | 2005-11-21 |
| 1770583817 | Robert Mario Dasilva | Orthopaedic Surgery | 1910 Blanding St, Columbia, SC 29201-3520 | 2005-07-29 |
| 1619575958 | Lexington Health Inc | Orthopaedic Surgery | 146 E Hospital Dr Ste 350, West Columbia, SC 29169-4800 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
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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.