CLARENCE WILLIAM WIMBERLY JR. (NPI# 1932190139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932190139 |
| Entity Type | Individual |
| Full Name | CLARENCE WILLIAM WIMBERLY JR. |
| Credential | MD |
| Practice Address |
435 N Cedar St Summerville SC 29483-6407 |
| Mailing Address |
201 Sigma Drive Suite 100 Summerville SC 29486-7722 |
| Practice Telephone | 8438731592 |
| Practice Fax Number | 8438712936 |
| Mailing Telephone | 8438731592 |
| Mailing Fax Number | 8438712936 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2019-04-17 |
| NPI Deactivation Date | 03/29/2019 |
| NPI Reactivation Date | 2019-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5740 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 057404 | 05 | |
| SC | RR MEDICARE | P01396493 | 01 |
| Street Address |
435 N CEDAR ST |
| City | SUMMERVILLE |
| State | SC |
| Zip Code | 29483-6407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447749015 | Alisa G. Whittington | Nurse Practitioner | 435 N Cedar St, Summerville, SC 29483 | 2018-05-09 |
| 1316456478 | Jennifer Repaskey | Physician Assistant | 435 N Cedar St, Summerville, SC 29483-6407 | 2017-09-21 |
| 1144630716 | Palmetto Primary Care Physicians | Family Medicine | 435 N Cedar St, Summerville, SC 29483-6407 | 2014-05-05 |
| 1588965511 | James H. Moody Jr. | Counselor | 435 N Cedar St, Summerville, SC 29483-6407 | 2010-11-08 |
| 1205942943 | Shirley L Ho | Physician Assistant | 435 N Cedar St, Summerville, SC 29483-6407 | 2006-08-23 |
| 1023023827 | Caroline M Yerich | Nurse Practitioner | 435 N Cedar St, Summerville, SC 29483-6407 | 2006-07-30 |
| 1518905488 | Robin Joseph | Counselor | 435 N Cedar St, Summerville, SC 29483-6407 | 2006-06-03 |
| 1396703740 | Jack Allan Stauffer | Nurse Practitioner | 435 N Cedar St, Summerville, SC 29483-6407 | 2006-05-03 |
| 1215994959 | Brian Keith Keller | Family Medicine | 435 N Cedar St, Summerville, SC 29483 | 2006-04-27 |
| 1982685012 | Brenda Gale Vaughan | Social Worker | 435 N Cedar St, Summerville, SC 29483-6407 | 2005-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764347 | Catherine M Bixler | Counselor | 314 W 4th St N, Summerville, SC 29483 | 2020-09-09 |
| 1255979431 | Jeanette Louise Virden | Counselor | 200 E 5th North Street, Summerville, SC 29483 | 2019-12-18 |
| 1912477415 | Kaylee Lobo | Nurse Practitioner | 203 Pavilion Street, Summerville, SC 29483 | 2018-11-28 |
| 1962981142 | Jackson Pediatric Dentistry of Summerville | Dentist | 405 West 4th Street North, Summerville, SC 29483 | 2018-08-09 |
| 1558885483 | Allied Medical Respiratory | Durable Medical Equipment & Medical Supplies | 200 W 5th North Street, Summerville, SC 29483 | 2017-08-02 |
| 1336671296 | Natalie M Clark | Specialist/Technologist | 102 Green Wave Boulevard, Dorchester School District Two, Summerville, SC 29483 | 2017-03-30 |
| 1649701897 | Usv Optical Inc. | Technician/Technologist | 1035 Jockey Ct., Summerville, SC 29483 | 2017-03-21 |
| 1497113617 | Roper Saint Francis Physicians Network | Surgery | 1112 N Main St Ste C, Summerville, SC 29483 | 2016-02-02 |
| 1083000798 | Andrea Sartori | Clinical Neuropsychologist | 107 W 5th North St Ste 102, Summerville, SC 29483 | 2015-04-09 |
| 1376931626 | Wendy Davis-jones | Home Health Aide | 203 Lakepointe Ave, Summerville, SC 29483 | 2015-01-08 |
| Find all providers in zip 29483 | ||||
| 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 |
|---|---|---|---|---|
| 1932652856 | Medprimary LLC | Family Medicine | 103b Harth Pl, Summerville, SC 29485-8107 | 2016-07-27 |
| 1265893705 | Roper Saint Francis Physicians Network | Family Medicine | 1525 Old Trolley Rd Ste H, Summerville, SC 29485-8928 | 2016-03-11 |
| 1740647650 | Palmetto Primary Care Physicians, LLC | Family Medicine | 201 Sigma Dr, Ste 100, Summerville, SC 29486-7715 | 2016-01-22 |
| 1043654700 | Merritt Stanley Huber IIi | Family Medicine | 2000 1st Avenue, Summerville, SC 29486 | 2013-04-24 |
| 1982048062 | Summerville Primary Care | Family Medicine | 299-a Midland Parkway, Summerville, SC 29485 | 2013-04-19 |
| 1710274295 | Jennifer R. Stolin | Family Medicine | 90 Springview Ln Ste A, Summerville, SC 29485-8153 | 2011-07-05 |
| 1497075733 | Palmetto Primary Care Physicians | Family Medicine | 300 W 4th North St, Summerville, SC 29483-6550 | 2010-06-09 |
| 1265667828 | Christina Douglass | Family Medicine | 11766 Hwy 27 North, Summerville, GA 30747 | 2009-05-26 |
| 1194986299 | Marie E Neilsen | Family Medicine | 9500 Dorchester Rd Ste 362, Summerville, SC 29485-4304 | 2008-06-20 |
| 1407992803 | Steven John Lenes | Family Medicine | 9995 Jamison Rd., Summerville, SC 29485 | 2007-01-30 |
| Find all providers in SUMMERVILLE | ||||
| City | SUMMERVILLE |
| Zip Code | 29483 |
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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.