SPARTANBURG REGIONAL MED CTR (NPI# 1851332696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851332696 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG REGIONAL MED CTR |
| Other Organization Name | EASTSIDE MED ASSOC-SENIOR HEALTH |
| Practice Address |
120 Heywood Ave Spartanburg SC 29302-1210 |
| Mailing Address |
Po Box 2168 Spartanburg SC 29304-2168 |
| Practice Telephone | 8645603861 |
| Practice Fax Number | 8645603712 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SUSAN BRUCE (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8645604304 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1118 | 05 |
| Other Name | Type Code |
|---|---|
| EASTSIDE MED ASSOC-SENIOR HEALTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710918230 | Spartanburg Regional Med Ctr | Psychiatry & Neurology | 853 N Church Street, Suite 640, Spartanburg, SC 29303-3040 | 2006-07-05 |
| 1710922703 | Spartanburg Regional Med Ctr | Pediatrics | 3941 Hwy 9, Ste B, Boiling Springs, SC 29316 | 2006-06-17 |
| 1023392883 | Spartanburg Regional Med Ctr | Pediatrics | 853 N Church St, Suite 401, Spartanburg, SC 29303-3098 | 2011-09-28 |
| 1700176054 | Spartanburg Regional Med Ctr | Plastic Surgery | 29 Rocky Slope Rd, Greenville, SC 29607-3909 | 2011-04-07 |
| 1588998629 | Spartanburg Regional Med Ctr | Internal Medicine | 322 Memorial Dr, Greer, SC 29650-1521 | 2009-09-22 |
| 1417281650 | Spartanburg Regional Med Ctr | Internal Medicine | 325 Medical Pkwy, Suite 200, Greer, SC 29650-2457 | 2009-09-21 |
| 1922243674 | Spartanburg Regional Med Ctr | Obstetrics & Gynecology | 373 Halton Rd, Greenville, SC 29607-3405 | 2008-12-10 |
| 1497900641 | Spartanburg Regional Med Ctr | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2008-12-01 |
| 1568616076 | Spartanburg Regional Med Ctr | Internal Medicine | 1702 Skylyn Dr, Unit C, Spartanburg, SC 29307-1040 | 2008-11-11 |
| 1730376948 | Spartanburg Regional Med Ctr | Obstetrics & Gynecology | 1686 Skylyn Dr, Suite 102, Spartanburg, SC 29307-1058 | 2007-10-02 |
| Street Address |
120 HEYWOOD AVE |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302-1210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184694168 | Scott A Coley | Family Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-01-24 |
| 1164865473 | Janessa M. Perez-motlis | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2013-04-17 |
| 1316293947 | Jamie Lynn Kilcoyne | Nurse Practitioner | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2012-08-01 |
| 1306000948 | Vincent C Slater | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302 | 2008-07-14 |
| 1356476584 | Spartanburg Regional Healthcare District | Durable Medical Equipment & Medical Supplies | 120 Heywood Ave, Suite 400, Spartanburg, SC 29302-1210 | 2007-02-21 |
| 1003900143 | Spartanburg Medical Center | Internal Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-10-03 |
| 1558381541 | Spartanburg Medical Center | Home Health | 120 Heywood Ave, Suite 300, Spartanburg, SC 29302-1210 | 2006-07-20 |
| 1942241781 | Spartanburg Regional Med Ctr | Family Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-06-10 |
| 1194779017 | Philip A Mahoney Jr. | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2006-05-22 |
| 1356393680 | George Liston Bass | Internal Medicine | 120 Heywood Ave, Ste 200, Spartanburg, SC 29302-1210 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922045103 | Network Geriatric Services, Pa | Family Medicine | 103 S Pine St, Spartanburg, SC 29302-1972 | 2006-05-31 |
| 1164470159 | Robert Eric Houston | Family Medicine | 853 N Church St, Suite 510, Spartanburg, SC 29303-3098 | 2006-05-04 |
| 1952368953 | Garrett E. Snipes | Family Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-04-26 |
| 1427020239 | Patricia Mcrobbie | Family Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-02-06 |
| 1396717682 | Spartanburg Regional Healthcare System | Family Medicine | 120 Heywood Ave, Suite 300, Spartanburg, SC 29302-1210 | 2006-02-02 |
| 1750352332 | Spartanburg Regional Healthcare System | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2006-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487031001 | Charleston Geriatrics and Post - Acute Care LLC | Family Medicine | 930 Tall Pine Rd, Mount Pleasant, SC 29464-2910 | 2015-05-04 |
| 1699041160 | Sarah E Whitehead | Family Medicine | Paris View Family Medicine, 1028 North Church Street, Greenville, SC 29601-1639 | 2012-03-28 |
| 1376854406 | Liberty Doctors, LLC | Family Medicine | 8761 Dorchester Rd, Suite 230, North Charleston, SC 29420-7322 | 2010-06-23 |
| 1720310055 | Green Ridge Group Inc | Family Medicine | 100 Forum Dr, Ste 3-255, Columbia, SC 29229-7944 | 2010-02-11 |
| 1306076542 | Veena G Naidu | Family Medicine | 203 Sapphire Vly, Anderson, SC 29621-4285 | 2009-07-22 |
| 1922236751 | Roper Saint Francis Physicians Network | Family Medicine | 4959 Highway 17, Murrells Inlet, SC 29576 | 2009-07-01 |
| 1265696439 | St. Andrews Surgical Assoc. PC | Family Medicine | 1006 Old Chapin Rd, Lexington, SC 29072-9549 | 2008-07-16 |
| 1417146127 | Russell G. Gaddy M.d. | Family Medicine | 10 Winchester Ct, Mauldin, SC 29662-2627 | 2007-10-18 |
| 1982724241 | Mark J. Meiler, Md | Family Medicine | 124 Live Oak Rd, Aiken, SC 29803-2663 | 2007-03-30 |
| 1518090901 | Andres Felix Leone | Family Medicine | 3 Richland Medical Park Dr Ste 510, Columbia, SC 29203-6854 | 2007-03-14 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
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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.