| Spartanburg Medical Center | |
|
3981 Highway 9 Boiling Springs SC 29316-8578 | |
| (864) 560-3650 | |
| (864) 560-3675 |
| Full Name | Spartanburg Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 3981 Highway 9, Boiling Springs, South Carolina |
| Authorized Official Name and Position | Kenneth Meinke (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8645606000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spartanburg Medical Center Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4304 | Spartanburg Medical Center 3981 Highway 9 Boiling Springs SC 29316-8578 Ph: (864) 560-3650 |
| NPI Number | 1235170077 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 02/03/2021 |
| Medicare PECOS PAC ID | 3072425297 |
|---|---|
| Medicare Enrollment ID | O20040322000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235170077 | NPI | - | NPPES |
| GP5710 | Medicaid | SC | |
| GP1118 | Medicaid | SC | |
| CN1627 | Other | SC | RAILROAD MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gregory T Valainis |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215906151 PECOS PAC ID: 8426962234 Enrollment ID: I20031117000360 |
| Provider Name | Mark E Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194791061 PECOS PAC ID: 9739084054 Enrollment ID: I20031201000344 |
| Provider Name | Tod R Reel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619952736 PECOS PAC ID: 9931006715 Enrollment ID: I20031218000663 |
| Provider Name | Timothy J Rop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447220348 PECOS PAC ID: 6305828450 Enrollment ID: I20040603000214 |
| Provider Name | Philip Andrew Mahoney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194779017 PECOS PAC ID: 8224010061 Enrollment ID: I20040604000162 |
| Provider Name | Brian Edward Wysong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912930009 PECOS PAC ID: 8628050432 Enrollment ID: I20040604000685 |
| Provider Name | Edward Leons Katemba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811906381 PECOS PAC ID: 1254313976 Enrollment ID: I20040604000776 |
| Provider Name | John E Melba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649229923 PECOS PAC ID: 0345224903 Enrollment ID: I20040614000622 |
| Provider Name | Richard J Ruffing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689628646 PECOS PAC ID: 7315923315 Enrollment ID: I20040629001083 |
| Provider Name | Yoganand J Hiremath |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952377863 PECOS PAC ID: 3274519020 Enrollment ID: I20040712000485 |
| Provider Name | Howard C Bean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760434120 PECOS PAC ID: 2860472784 Enrollment ID: I20040721001693 |
| Provider Name | Ginger Blatchford Boyle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043298011 PECOS PAC ID: 2163402413 Enrollment ID: I20040726000770 |
| Provider Name | Nichole Lynn Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538239587 PECOS PAC ID: 9537132998 Enrollment ID: I20040816000204 |
| Provider Name | Marc David Bingham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629049515 PECOS PAC ID: 9830162163 Enrollment ID: I20040816000819 |
| Provider Name | James M Gragg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932170701 PECOS PAC ID: 1557336856 Enrollment ID: I20040831000373 |
| Provider Name | Preston Eddie Bishop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801866181 PECOS PAC ID: 0143297762 Enrollment ID: I20040914000251 |
| Provider Name | Robert E Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710965637 PECOS PAC ID: 5890751614 Enrollment ID: I20041203000397 |
| Provider Name | Charlotte Hatchell Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396799631 PECOS PAC ID: 6204894827 Enrollment ID: I20041229000757 |
| Provider Name | Robert Macdonald |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528035425 PECOS PAC ID: 3274584537 Enrollment ID: I20050203000375 |
| Provider Name | Robert Earl Mcdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669452793 PECOS PAC ID: 4688621444 Enrollment ID: I20050404000723 |
| Provider Name | Kameron Klosterman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609984715 PECOS PAC ID: 8426095480 Enrollment ID: I20050411001290 |
| Provider Name | Susan K Bland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982657151 PECOS PAC ID: 6608815964 Enrollment ID: I20050427000421 |
| Provider Name | Mayte L Sandrin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1437129525 PECOS PAC ID: 3971547142 Enrollment ID: I20050617000805 |
| Provider Name | Dewey Todd Detar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750499604 PECOS PAC ID: 6305872029 Enrollment ID: I20050714000224 |
| Provider Name | Howard William Klickman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174594477 PECOS PAC ID: 8224012919 Enrollment ID: I20050912000046 |
| Provider Name | Henry G Cupstid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477506673 PECOS PAC ID: 3375561855 Enrollment ID: I20051103000155 |
| Provider Name | Michelle Bruce Nobles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992777007 PECOS PAC ID: 1153343363 Enrollment ID: I20051230000279 |
| Provider Name | Henry Shugart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134195126 PECOS PAC ID: 3870509201 Enrollment ID: I20060222000681 |
| Provider Name | Melody Kneeland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871655431 PECOS PAC ID: 0244205086 Enrollment ID: I20060420000376 |
| Provider Name | Gary D Rauch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194705970 PECOS PAC ID: 9739192402 Enrollment ID: I20060725000018 |
| Provider Name | Lisa A Swann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972574242 PECOS PAC ID: 1658347281 Enrollment ID: I20060725000023 |
| Provider Name | Salvatore Bianco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023089919 PECOS PAC ID: 7719990480 Enrollment ID: I20060725000036 |
| Provider Name | Molly Carolyn Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508853649 PECOS PAC ID: 3375547664 Enrollment ID: I20060829000047 |
| Provider Name | Richard G Leland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184659880 PECOS PAC ID: 5698772358 Enrollment ID: I20061023000397 |
| Provider Name | Carla Franklin Gentry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801867577 PECOS PAC ID: 4082613815 Enrollment ID: I20061205000485 |
| Provider Name | Deepak Malhan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265457691 PECOS PAC ID: 0143133090 Enrollment ID: I20061205000597 |
| Provider Name | Troy D Mccurry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255386520 PECOS PAC ID: 6406856244 Enrollment ID: I20070102000064 |
| Provider Name | Laine P Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861427205 PECOS PAC ID: 3678573755 Enrollment ID: I20070115000213 |
| Provider Name | James L Bridgeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700811593 PECOS PAC ID: 7214937390 Enrollment ID: I20070115000217 |
| Provider Name | James E Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639104375 PECOS PAC ID: 9931109014 Enrollment ID: I20070115000225 |
| Provider Name | Joseph W Derosa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649205378 PECOS PAC ID: 7012917198 Enrollment ID: I20070115000230 |
| Provider Name | Herbert F Barnhill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205888674 PECOS PAC ID: 4880797562 Enrollment ID: I20070319000187 |
| Provider Name | Caroline Dy-go |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497712673 PECOS PAC ID: 1557465275 Enrollment ID: I20070404000639 |
| Provider Name | Donald Todd Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841243078 PECOS PAC ID: 5698870178 Enrollment ID: I20070411000180 |
| Provider Name | Matthew J Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700842333 PECOS PAC ID: 6901901818 Enrollment ID: I20070423000293 |
| Provider Name | Sumer S Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740306034 PECOS PAC ID: 0749388098 Enrollment ID: I20070611000032 |
| Provider Name | Douglas J Rieth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225004229 PECOS PAC ID: 2567555808 Enrollment ID: I20070904000074 |
| Provider Name | Jeffrey N Clary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902872906 PECOS PAC ID: 5799878054 Enrollment ID: I20070904000178 |
| Provider Name | Coy L Eaton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245206234 PECOS PAC ID: 0244323509 Enrollment ID: I20070904000182 |
| Provider Name | Sherley Ivette Brito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679556567 PECOS PAC ID: 3274556287 Enrollment ID: I20080220000360 |
| Provider Name | Robin Go |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1629068036 PECOS PAC ID: 3476503962 Enrollment ID: I20080917000517 |
| Provider Name | John Fowler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538131933 PECOS PAC ID: 2961561618 Enrollment ID: I20081110000523 |
| Provider Name | Steven A Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952388746 PECOS PAC ID: 6800978503 Enrollment ID: I20090319000469 |
| Provider Name | Paul A Gulledge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194855502 PECOS PAC ID: 3274671581 Enrollment ID: I20091106000191 |
| Provider Name | Jennifer Baugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558332544 PECOS PAC ID: 1355482217 Enrollment ID: I20100114000278 |
| Provider Name | Gregory L Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184695918 PECOS PAC ID: 6204978869 Enrollment ID: I20100120000055 |
| Provider Name | Frances Mixson Kunda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609852391 PECOS PAC ID: 4981742970 Enrollment ID: I20100226000843 |
| Provider Name | Patrick J Esposito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922078823 PECOS PAC ID: 9234274234 Enrollment ID: I20100302000490 |
| Provider Name | Annette Bennett Burnett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861691487 PECOS PAC ID: 2365636362 Enrollment ID: I20101103001290 |
| Provider Name | Manuel A Dorna-pesquera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689650376 PECOS PAC ID: 7618015603 Enrollment ID: I20110104000932 |
| Provider Name | Elizabeth Youngs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043204266 PECOS PAC ID: 0042239048 Enrollment ID: I20110308000753 |
| Provider Name | Vincent Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306000948 PECOS PAC ID: 6204004591 Enrollment ID: I20110712000163 |
| Provider Name | Christopher Michael Cutshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649438052 PECOS PAC ID: 5294905725 Enrollment ID: I20110819000016 |
| Provider Name | Donna-marie Koroma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457366262 PECOS PAC ID: 1153317367 Enrollment ID: I20120328000648 |
| Provider Name | Jessica Lynn Pollard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437387529 PECOS PAC ID: 9234393372 Enrollment ID: I20120621000100 |
| Provider Name | Wayne Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215165741 PECOS PAC ID: 6204082027 Enrollment ID: I20120810000351 |
| Provider Name | Jamie L Kilcoyne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316293947 PECOS PAC ID: 5294982740 Enrollment ID: I20120906000037 |
| Provider Name | Troy Mac Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194994210 PECOS PAC ID: 6608930847 Enrollment ID: I20121020000030 |
| Provider Name | Ryan B Tuttle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730471681 PECOS PAC ID: 4284884594 Enrollment ID: I20121023000354 |
| Provider Name | Brent Edward Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215256839 PECOS PAC ID: 6608027164 Enrollment ID: I20121108000585 |
| Provider Name | Chad A Leep |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073741500 PECOS PAC ID: 3577717560 Enrollment ID: I20130128000421 |
| Provider Name | Timothy J Burrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457672289 PECOS PAC ID: 3173777042 Enrollment ID: I20130129000653 |
| Provider Name | Mark P Doran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649211913 PECOS PAC ID: 2961412879 Enrollment ID: I20130627000091 |
| Provider Name | Sheryl M Bankston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972859130 PECOS PAC ID: 8224278486 Enrollment ID: I20130711000303 |
| Provider Name | Margaret R Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477880755 PECOS PAC ID: 9931346525 Enrollment ID: I20130819000352 |
| Provider Name | Doshandra N Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932334786 PECOS PAC ID: 0244468874 Enrollment ID: I20140106000711 |
| Provider Name | Lisa M Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467874255 PECOS PAC ID: 8224269501 Enrollment ID: I20140331000496 |
| Provider Name | Lori A Morrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023433232 PECOS PAC ID: 1759513989 Enrollment ID: I20140422001293 |
| Provider Name | Cassandra Lynn Drummond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720417116 PECOS PAC ID: 8921221359 Enrollment ID: I20140603001194 |
| Provider Name | Jason Lee Watters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316286339 PECOS PAC ID: 8022330844 Enrollment ID: I20141205002089 |
| Provider Name | Stephanie Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083003065 PECOS PAC ID: 2264759083 Enrollment ID: I20150316001178 |
| Provider Name | David Howard Whiteside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003205626 PECOS PAC ID: 6901127513 Enrollment ID: I20150608003072 |
| Provider Name | Joshua Brady Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639581119 PECOS PAC ID: 5597078436 Enrollment ID: I20150721001247 |
| Provider Name | Jennifer D Psaltis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033590575 PECOS PAC ID: 9335453364 Enrollment ID: I20150804003934 |
| Provider Name | Alicia Dawn Womack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538541792 PECOS PAC ID: 4880900455 Enrollment ID: I20150826002807 |
| Provider Name | Kevin Patrick Docyk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548588163 PECOS PAC ID: 4981828084 Enrollment ID: I20150831002243 |
| Provider Name | Ann T Bartee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730569328 PECOS PAC ID: 1759697188 Enrollment ID: I20150901000104 |
| Provider Name | Hina Anjum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336409986 PECOS PAC ID: 7315256344 Enrollment ID: I20151014001603 |
| Provider Name | Christopher Todd Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114300845 PECOS PAC ID: 9537469390 Enrollment ID: I20151130001242 |
| Provider Name | Melissa B Kimbrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790153203 PECOS PAC ID: 9032419742 Enrollment ID: I20151202002189 |
| Provider Name | Silvestro J Lijoi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780679118 PECOS PAC ID: 7012996135 Enrollment ID: I20151216002463 |
| Provider Name | Laurie Michelle Runyans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700259314 PECOS PAC ID: 8123325461 Enrollment ID: I20160331000510 |
| Provider Name | Brittany Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558735241 PECOS PAC ID: 7315245131 Enrollment ID: I20160412001176 |
| Provider Name | Felicia Tapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538514351 PECOS PAC ID: 2860784014 Enrollment ID: I20160707001981 |
| Provider Name | Amber D Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780032631 PECOS PAC ID: 9739476649 Enrollment ID: I20160921000021 |
| Provider Name | Dorian R Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821440215 PECOS PAC ID: 3870881766 Enrollment ID: I20161010000247 |
| Provider Name | Kristen D Deluna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750834198 PECOS PAC ID: 1951689629 Enrollment ID: I20161101000006 |
| Provider Name | Christine W Bright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629526231 PECOS PAC ID: 7012296080 Enrollment ID: I20161115000810 |
| Provider Name | April Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649623323 PECOS PAC ID: 9830478718 Enrollment ID: I20161116002617 |
| Provider Name | Rebecca Lynne Brenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205387388 PECOS PAC ID: 7012298441 Enrollment ID: I20161227000366 |
| Provider Name | Candace G Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023550894 PECOS PAC ID: 6608159173 Enrollment ID: I20170207001225 |
| Provider Name | Dianna Michelle Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932657640 PECOS PAC ID: 7214217058 Enrollment ID: I20170215000678 |
| Provider Name | Melodie G Hanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043752579 PECOS PAC ID: 9638453376 Enrollment ID: I20170224001844 |
| Provider Name | Heather Michelle Lawter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861926685 PECOS PAC ID: 3072883610 Enrollment ID: I20170714001064 |
| Provider Name | Kelly C Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649703109 PECOS PAC ID: 7113298399 Enrollment ID: I20170807000919 |
| Provider Name | Casey Collins Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578092250 PECOS PAC ID: 9335410265 Enrollment ID: I20170810001246 |
| Provider Name | Betsey Collins Scruggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902327760 PECOS PAC ID: 9739452673 Enrollment ID: I20170829001366 |
| Provider Name | Whitney Kendall Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467976720 PECOS PAC ID: 5890069603 Enrollment ID: I20170918002077 |
| Provider Name | Melody E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114441458 PECOS PAC ID: 9436424967 Enrollment ID: I20171009001646 |
| Provider Name | John Frederick Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487178844 PECOS PAC ID: 0648545020 Enrollment ID: I20171011001501 |
| Provider Name | Laura B Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700314754 PECOS PAC ID: 1759656044 Enrollment ID: I20171012002737 |
| Provider Name | Julie S Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740704055 PECOS PAC ID: 7416214481 Enrollment ID: I20171129001346 |
| Provider Name | Kathleen H Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548789019 PECOS PAC ID: 7911265749 Enrollment ID: I20171227001247 |
| Provider Name | Brittany Earnhardt Saleeby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275057770 PECOS PAC ID: 4587924543 Enrollment ID: I20180213000030 |
| Provider Name | Kathleen Gilfillan Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649789579 PECOS PAC ID: 5799046108 Enrollment ID: I20180228000443 |
| Provider Name | Sybil Angelene Tezza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750801791 PECOS PAC ID: 7719242833 Enrollment ID: I20180521000498 |
| Provider Name | Alexander T Hray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083909121 PECOS PAC ID: 1052668514 Enrollment ID: I20180716002168 |
| Provider Name | Daniel Paul Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740675750 PECOS PAC ID: 4284983446 Enrollment ID: I20180821001994 |
| Provider Name | Amanda Kinney Pruitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033505524 PECOS PAC ID: 3779891627 Enrollment ID: I20180919004015 |
| Provider Name | Katherine E Enos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528451002 PECOS PAC ID: 0648588384 Enrollment ID: I20180927002940 |
| Provider Name | Christian H Richey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497105910 PECOS PAC ID: 7517255870 Enrollment ID: I20181001001801 |
| Provider Name | Emily B Staggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023498938 PECOS PAC ID: 5991013641 Enrollment ID: I20181001002767 |
| Provider Name | Christopher Julian Keating |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407296759 PECOS PAC ID: 4688996788 Enrollment ID: I20181011001732 |
| Provider Name | Jamie T Burns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295114742 PECOS PAC ID: 7517275258 Enrollment ID: I20181106001104 |
| Provider Name | Jennifer A Melegari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275764045 PECOS PAC ID: 2668512732 Enrollment ID: I20181130002286 |
| Provider Name | Jennifer Ann Kollock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740755891 PECOS PAC ID: 2062756513 Enrollment ID: I20181210003342 |
| Provider Name | Cyril A Forcha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831662048 PECOS PAC ID: 7618215922 Enrollment ID: I20190212002375 |
| Provider Name | Cory Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083950935 PECOS PAC ID: 1557600640 Enrollment ID: I20190307001874 |
| Provider Name | James P Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902361611 PECOS PAC ID: 6305186214 Enrollment ID: I20190312002840 |
| Provider Name | Sheila R Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194298299 PECOS PAC ID: 7719227586 Enrollment ID: I20190314002350 |
| Provider Name | Heather C Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124583117 PECOS PAC ID: 4486995230 Enrollment ID: I20190404002446 |
| Provider Name | Benjamin S Friday |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922369123 PECOS PAC ID: 2860613098 Enrollment ID: I20190702003192 |
| Provider Name | Amber C Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235795246 PECOS PAC ID: 3072849215 Enrollment ID: I20190725003527 |
| Provider Name | Jodi Cameron Crocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265984678 PECOS PAC ID: 2567791403 Enrollment ID: I20190903000585 |
| Provider Name | David M Cykert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154777456 PECOS PAC ID: 3375834757 Enrollment ID: I20191001001669 |
| Provider Name | Michelle K Sayles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174975809 PECOS PAC ID: 8921393331 Enrollment ID: I20191018002581 |
| Provider Name | Sally C Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598318966 PECOS PAC ID: 9638501414 Enrollment ID: I20191115002243 |
| Provider Name | Mark W Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578116943 PECOS PAC ID: 1254766884 Enrollment ID: I20200108002509 |
| Provider Name | Jaimie Elizabeth Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861039687 PECOS PAC ID: 6901232867 Enrollment ID: I20200212002468 |
| Provider Name | Alisha Cartledge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225677297 PECOS PAC ID: 3779910070 Enrollment ID: I20200226002083 |
| Provider Name | Joseph Anthony Destefano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275190738 PECOS PAC ID: 9436570926 Enrollment ID: I20200610000184 |
| Provider Name | Geevan Alex George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578097176 PECOS PAC ID: 6507137833 Enrollment ID: I20200910000897 |
| Provider Name | Santoshi Lattupally |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700308178 PECOS PAC ID: 3173867488 Enrollment ID: I20201008001946 |
| Provider Name | Marcus Ashton Washington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225026479 PECOS PAC ID: 7911979018 Enrollment ID: I20201029000545 |
| Provider Name | Alyssa Marie Sherrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649895251 PECOS PAC ID: 0648684480 Enrollment ID: I20210205001806 |
| Provider Name | Samantha Marie Blackwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164007381 PECOS PAC ID: 0648687202 Enrollment ID: I20210326000035 |
| Provider Name | Shareda Mickelle Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407447352 PECOS PAC ID: 8820405467 Enrollment ID: I20210329000889 |
| Provider Name | Lauren Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396326054 PECOS PAC ID: 9830507367 Enrollment ID: I20210421001235 |
| Provider Name | Jonathan Sawaya Lekoshere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720499775 PECOS PAC ID: 8921322355 Enrollment ID: I20210706001679 |
| Provider Name | Elyn Lanfranco Delgado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225523731 PECOS PAC ID: 4587066311 Enrollment ID: I20210715002168 |
| Provider Name | Elizabeth Page Kiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780179812 PECOS PAC ID: 9335489152 Enrollment ID: I20210805002810 |
| Provider Name | Lane Robert Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659374122 PECOS PAC ID: 8022024843 Enrollment ID: I20210816001376 |
| Provider Name | Margarite Helen Elsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285396242 PECOS PAC ID: 6608265277 Enrollment ID: I20211120000012 |
| Provider Name | Marize Paulema Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972121507 PECOS PAC ID: 7012301781 Enrollment ID: I20220222002039 |
| Provider Name | Stacie Horne Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033731237 PECOS PAC ID: 4284016890 Enrollment ID: I20220728003366 |
| Provider Name | Timothy Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841945839 PECOS PAC ID: 6406238823 Enrollment ID: I20220802001953 |
| Provider Name | Amy Oneal Bunch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568179497 PECOS PAC ID: 8325416878 Enrollment ID: I20221115001577 |
| Provider Name | Casey Jean Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497479349 PECOS PAC ID: 3870961816 Enrollment ID: I20221122001614 |
| Provider Name | Michelle Jones-moon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750943288 PECOS PAC ID: 1759718588 Enrollment ID: I20221205001382 |
| Provider Name | Kelly Cudd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396454724 PECOS PAC ID: 7315316528 Enrollment ID: I20221209002834 |
| Provider Name | Kirsten C Harkness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053016261 PECOS PAC ID: 2567820350 Enrollment ID: I20230627001604 |
| Provider Name | Brittney Doornbos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346862638 PECOS PAC ID: 2264859727 Enrollment ID: I20230630002733 |
| Provider Name | Laura Elizabeth Galloway |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003444092 PECOS PAC ID: 5294166252 Enrollment ID: I20230711003855 |
| Provider Name | Kristy Elizabeth Reutlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538845656 PECOS PAC ID: 9739542507 Enrollment ID: I20230825002860 |
| Provider Name | Maliha Marino Taufiq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841814670 PECOS PAC ID: 1557786365 Enrollment ID: I20230901000925 |
| Provider Name | Baolam Ngoc Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023632858 PECOS PAC ID: 6800211632 Enrollment ID: I20230922003757 |
| Provider Name | Shane Gregory Reighard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588028880 PECOS PAC ID: 5890081087 Enrollment ID: I20231024000270 |
| Provider Name | Katherine Marie Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932989183 PECOS PAC ID: 6709233778 Enrollment ID: I20231113002566 |
| Provider Name | Geoffrey Briant Zander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801662804 PECOS PAC ID: 3971952953 Enrollment ID: I20231215002763 |
| Provider Name | Igor N Bedarev |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497069918 PECOS PAC ID: 5395985048 Enrollment ID: I20240205001777 |
| Provider Name | Christina Lynn Gentry Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497535025 PECOS PAC ID: 1850737156 Enrollment ID: I20240308002489 |
| Provider Name | Emily Meshey Kaufman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306600887 PECOS PAC ID: 9335688803 Enrollment ID: I20240828002160 |
| Provider Name | Alison Markley Renner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366029662 PECOS PAC ID: 5597169458 Enrollment ID: I20240923000048 |
| Provider Name | Kristen Landy Starnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457931149 PECOS PAC ID: 3870996150 Enrollment ID: I20240925002239 |
| Provider Name | Allison Dyer Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114750734 PECOS PAC ID: 1658803507 Enrollment ID: I20241016002343 |
| Provider Name | Elizabeth Rene' Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972243699 PECOS PAC ID: 9830573252 Enrollment ID: I20241031000239 |
| Provider Name | Christopher Nou Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093060360 PECOS PAC ID: 0941525091 Enrollment ID: I20250423003542 |
Mary Black Physicians Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2212 Old Furnace Rd, Boiling Springs, SC 29316 Phone: 864-578-9735 | |
Carolina Children's Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 Village Creek Dr, Boiling Springs, SC 29316 Phone: 864-327-9003 | |
Family Physicians Of Boiling Springs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3941 Highway 9, Boiling Springs, SC 29316 Phone: 864-560-3650 Fax: 864-560-3675 |