| Centerwell Senior Primary Care (sc) Pc | |
|
101 Orchard Park Dr Greenville SC 29615-3531 | |
| (864) 729-6606 | |
| (855) 617-4426 |
| Full Name | Centerwell Senior Primary Care (sc) Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 Orchard Park Dr, Greenville, South Carolina |
| Authorized Official Name and Position | Erica L Savage-jeter (REGIONAL MEDICAL DIRECTOR) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care (sc) Pc 4700 Millenia Blvd Ste 650 Orlando FL 32839-6013 Ph: (407) 447-7120 | Centerwell Senior Primary Care (sc) Pc 101 Orchard Park Dr Greenville SC 29615-3531 Ph: (864) 729-6606 |
| NPI Number | 1376907790 |
|---|---|
| Provider Enumeration Date | 04/12/2016 |
| Last Update Date | 11/07/2022 |
| Medicare PECOS PAC ID | 2860804796 |
|---|---|
| Medicare Enrollment ID | O20201216002926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376907790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Marcella Ann Tabor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184681579 PECOS PAC ID: 0244134013 Enrollment ID: I20031124000018 |
| Provider Name | Joshua Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679539118 PECOS PAC ID: 7517944598 Enrollment ID: I20040707000976 |
| Provider Name | Christa Rigel Mccann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093814303 PECOS PAC ID: 0547207300 Enrollment ID: I20050413000297 |
| Provider Name | Sofia Isabel Barbosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891897369 PECOS PAC ID: 0749277911 Enrollment ID: I20050516000021 |
| Provider Name | Lynda M Mckinnon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922110956 PECOS PAC ID: 5092714014 Enrollment ID: I20061220000101 |
| Provider Name | Jony M Bolinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295787471 PECOS PAC ID: 1254331648 Enrollment ID: I20070109000357 |
| Provider Name | Brian David Lum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245359132 PECOS PAC ID: 7113010265 Enrollment ID: I20070905000387 |
| Provider Name | Stephanie Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861460883 PECOS PAC ID: 4284620774 Enrollment ID: I20080129000855 |
| Provider Name | James Spencer Gainey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417076373 PECOS PAC ID: 7719069376 Enrollment ID: I20080205000148 |
| Provider Name | Amit Ramniklal Pitalia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467478735 PECOS PAC ID: 6608933296 Enrollment ID: I20090326000192 |
| Provider Name | Erica Lache' Savage-jeter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275657694 PECOS PAC ID: 9739234584 Enrollment ID: I20090901000233 |
| Provider Name | Kam Wei Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891759510 PECOS PAC ID: 9234328238 Enrollment ID: I20110106000371 |
| Provider Name | Rebecca R Haskill Strowd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619995065 PECOS PAC ID: 5890979041 Enrollment ID: I20110412000820 |
| Provider Name | Maria M Negron Alvarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639363914 PECOS PAC ID: 6709030372 Enrollment ID: I20130206000591 |
| Provider Name | Jill Kessler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992935837 PECOS PAC ID: 2769615467 Enrollment ID: I20140505000499 |
| Provider Name | Stephen Charles Franks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275948309 PECOS PAC ID: 0143448720 Enrollment ID: I20140822001273 |
| Provider Name | Elizabeth Mary Hernick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144455601 PECOS PAC ID: 2466598974 Enrollment ID: I20150413000911 |
| Provider Name | Faustina Baafour Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285181990 PECOS PAC ID: 6103104278 Enrollment ID: I20161024002219 |
| Provider Name | Jessica Taylor Glymph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588108112 PECOS PAC ID: 6305120577 Enrollment ID: I20170307001925 |
| Provider Name | Ashley Nix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003298274 PECOS PAC ID: 3476859232 Enrollment ID: I20170606002425 |
| Provider Name | Karen Henrichsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225228240 PECOS PAC ID: 1951498575 Enrollment ID: I20170726000207 |
| Provider Name | Sarah L Fulaytar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356721179 PECOS PAC ID: 0143520957 Enrollment ID: I20170829000047 |
| Provider Name | Lorie Jolly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043638554 PECOS PAC ID: 2860754868 Enrollment ID: I20180402000534 |
| Provider Name | Gwendolyn E Bowers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306026554 PECOS PAC ID: 4183929995 Enrollment ID: I20180731000214 |
| Provider Name | Heather A Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821223256 PECOS PAC ID: 7416112982 Enrollment ID: I20190222002479 |
| Provider Name | Erin R Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841754595 PECOS PAC ID: 7719226992 Enrollment ID: I20190306000477 |
| Provider Name | Cynthia Marie Petermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033399134 PECOS PAC ID: 0648356444 Enrollment ID: I20190411002947 |
| Provider Name | Laquinta Jamette Glenn-reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841854502 PECOS PAC ID: 5496089351 Enrollment ID: I20190626001848 |
| Provider Name | Howard P Blount |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851337471 PECOS PAC ID: 8325126337 Enrollment ID: I20191231001104 |
| Provider Name | Amanda Mays Lack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124532528 PECOS PAC ID: 4082973847 Enrollment ID: I20200102002346 |
| Provider Name | Nancy E Trifilo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588615561 PECOS PAC ID: 8022002708 Enrollment ID: I20200311001970 |
| Provider Name | Brandi Lynn Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326416835 PECOS PAC ID: 5799047379 Enrollment ID: I20211007002383 |
| Provider Name | Jessica J. Meredith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194106674 PECOS PAC ID: 2668788233 Enrollment ID: I20211015001256 |
| Provider Name | Christina Xiong Linart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710224332 PECOS PAC ID: 3971744038 Enrollment ID: I20220217002047 |
| Provider Name | Amy Beth Raz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881669315 PECOS PAC ID: 2668645516 Enrollment ID: I20221021001350 |
| Provider Name | Ann Hundley Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841455896 PECOS PAC ID: 2365662889 Enrollment ID: I20230208003306 |
| Provider Name | Jeff Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588968903 PECOS PAC ID: 8729305156 Enrollment ID: I20230320001671 |
| Provider Name | John Arlington Dawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114985090 PECOS PAC ID: 6406820034 Enrollment ID: I20240216000515 |
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