| Blair Gault, | |
|
1888 Boiling Springs Rd, Boiling Springs, SC 29316 | |
| (866) 389-2727 | |
| Not Available |
| Full Name | Blair Gault |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 1888 Boiling Springs Rd, Boiling Springs, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003395385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 22024 (South Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Regenesis Organization Community Health Center | 8022928001 | 27 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194710426 PECOS PAC ID: 8022928001 Enrollment ID: O20050127000120 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548528714 PECOS PAC ID: 8022928001 Enrollment ID: O20160816002916 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457745952 PECOS PAC ID: 8022928001 Enrollment ID: O20170127000968 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982248852 PECOS PAC ID: 8022928001 Enrollment ID: O20210120001241 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558946376 PECOS PAC ID: 8022928001 Enrollment ID: O20220630000562 |
| Mailing Address | Practice Location Address |
|---|---|
| Blair Gault, 1888 Boiling Springs Rd, Boiling Springs, SC 29316-5124 Ph: () - | Blair Gault, 1888 Boiling Springs Rd, Boiling Springs, SC 29316 Ph: (866) 389-2727 |
Mrs. Constance Audrianna Mudda, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2400 Boiling Springs Rd, Boiling Springs, SC 29316 Phone: 864-599-0731 Fax: 864-599-0791 | |
Rebecca Joy Brown, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 316 Village Creek Dr, Boiling Springs, SC 29316 Phone: 864-327-9003 Fax: 800-253-0649 | |
Mary Elizabeth Macgregor, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 316 Village Creek Dr, Boiling Springs, SC 29316 Phone: 864-327-9003 | |
Virginia Lee Ivey-mingione, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 110 Parris Bridge Road, Boiling Springs, SC 29316 Phone: 864-599-1998 | |
Jennifer Nicole Gahan, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1888 Boiling Springs Rd, Boiling Springs, SC 29316 Phone: 864-599-0920 | |
Felisha Booker, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1214 Turning Leaf Cir, Boiling Springs, SC 29316 Phone: 864-814-8660 |