Kevin Randolph Rust (NPI# 1821172560, PAC ID# 8921176454) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1821172560 |
| PAC ID by PECOS | 8921176454 |
| Professional Enrollment ID | I20111011000033 |
| Full Name | Kevin Randolph Rust |
| Organization Legal Name | GREENWOOD EAR NOSE AND THROAT ASSOC PA |
| Address |
1015 Spring St Greenwood SC 29646-3831 |
| Phone Number | 8642276741 |
| Gender | M |
| Medical School | UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 2769550292 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420071 | SELF REGIONAL HEALTHCARE |
| 421301 | ABBEVILLE AREA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1015 Spring St, Greenwood, SC 29646-3831 | 8642276741 | GREENWOOD EAR NOSE AND THROAT ASSOC PA |
| Organization Legal Name | GREENWOOD EAR NOSE AND THROAT ASSOC PA |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory Tarasidis | Otolaryngology | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Heather H Armstrong | Qualified Audiologist | Greenwood Ear Nose and Throat Assoc Pa | 324 Professional Park Rd, Clinton, SC 29325-7625 |
| Kyle Wayne Scates | Otolaryngology | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Rebecca W Owens | Qualified Audiologist | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Arlene A Hicklin | Qualified Audiologist | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Street Address |
1015 SPRING ST |
| City | GREENWOOD |
| State | SC |
| Zip | 29646-3831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory Tarasidis | Otolaryngology | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Kyle Wayne Scates | Otolaryngology | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Rebecca W Owens | Qualified Audiologist | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Arlene A Hicklin | Qualified Audiologist | Greenwood Ear Nose and Throat Assoc Pa | 1015 Spring St, Greenwood, SC 29646-3831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sudie Moore Clem | Clinical Social Worker | 112 Bypass, Suite 225, Greenwood, SC 29646-1154 | |
| Lynn T Hemphill | Clinical Social Worker | 112 Bypass, Suite 225, Greenwood, SC 29646-1154 | |
| Bennie S Henderson | Nurse Practitioner | Nhc Healthcare-greenwood LLC | 437 E Cambridge Ave, Greenwood, SC 29646-2244 |
| Daisy Smith | Nurse Practitioner | Nhc Healthcare-greenwood LLC | 437 E Cambridge Ave, Greenwood, SC 29646-2244 |
| Paula B Haynes | Nurse Practitioner | Nhc Healthcare-greenwood LLC | 437 E Cambridge Ave, Greenwood, SC 29646-2244 |
| David E Knecht Jr. | Chiropractic | 201 Hampton Ave, Suite C, Greenwood, SC 29646-2271 | |
| Jennifer Hershberger | Ophthalmology | Greenwood Eye Clinic Pa | 665 W Alexander Rd, Greenwood, SC 29646-2301 |
| Timothy L. Austin | Ophthalmology | Greenwood Eye Clinic Pa | 665 W Alexander Rd, Greenwood, SC 29646-2301 |
| Stephanie Compton Turner | Ophthalmology | Greenwood Eye Clinic Pa | 665 W Alexander Rd, Greenwood, SC 29646-2301 |
| Brian Vahjen | Ophthalmology | Greenwood Eye Clinic Pa | 665 W Alexander Rd, Greenwood, SC 29646-2301 |
| Find all physicians in zip 29646 | |||
| City | GREENWOOD |
| Zip Code | 29646 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | GREENWOOD + OTOLARYNGOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.