| Traditions Health Of Greenville | |
|
109 Laurens Rd Ste 1a Greenville SC 29607-1860 | |
| (864) 288-5136 | |
| (864) 288-5166 |
| Full Name | Traditions Health Of Greenville |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 Laurens Rd Ste 1a, Greenville, South Carolina |
| Authorized Official Name and Position | David R Klementz (PRESIDENT & CEO) |
| Authorized Official Contact | 9797046547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Health Of Greenville 150 4th Ave N Ste 2300 Nashville TN 37219-2466 Ph: (979) 704-4657 | Traditions Health Of Greenville 109 Laurens Rd Ste 1a Greenville SC 29607-1860 Ph: (864) 288-5136 |
| NPI Number | 1679219083 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 1355589839 |
|---|---|
| Medicare Enrollment ID | O20220628002361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679219083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Steven Barnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134175557 PECOS PAC ID: 2860395621 Enrollment ID: I20040129000307 |
| Provider Name | Bouvia Mcdaniel-jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033596580 PECOS PAC ID: 4688982358 Enrollment ID: I20150929002343 |
| Provider Name | Brandy Marshay Morton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669048484 PECOS PAC ID: 0547662074 Enrollment ID: I20210707000968 |
| Provider Name | Jessica Mitchell Simpkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699444000 PECOS PAC ID: 5890184535 Enrollment ID: I20211117003089 |
| Provider Name | Tomeka D Payton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992085401 PECOS PAC ID: 5698036879 Enrollment ID: I20230112000629 |
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