| Uptown Family Practice | |
|
313 Main St Ste B Greenwood SC 29646-2757 | |
| (864) 229-4446 | |
| (864) 229-8037 |
| Full Name | Uptown Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 313 Main St Ste B, Greenwood, South Carolina |
| Authorized Official Name and Position | Lisa Y Gilmer (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8643960117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Uptown Family Practice 313 Main St Greenwood SC 29646-2757 Ph: (864) 229-4446 | Uptown Family Practice 313 Main St Ste B Greenwood SC 29646-2757 Ph: (864) 229-4446 |
| NPI Number | 1306979521 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 02/08/2013 |
| Medicare PECOS PAC ID | 5496707804 |
|---|---|
| Medicare Enrollment ID | O20050825000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306979521 | NPI | - | NPPES |
| CBP014 | Medicaid | SC | |
| FQC032 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| Provider Name | Leanne Y Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356546162 PECOS PAC ID: 4284725557 Enrollment ID: I20070801000558 |
| Provider Name | Bryan H Casey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750303806 PECOS PAC ID: 8527029768 Enrollment ID: I20071112000403 |
| Provider Name | Michael A Faircloth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326007097 PECOS PAC ID: 0648344606 Enrollment ID: I20080808000514 |
| Provider Name | Locke Eugene Simons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619947926 PECOS PAC ID: 9931274636 Enrollment ID: I20080814000485 |
| Provider Name | Dorian L Goldstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538221312 PECOS PAC ID: 2860568748 Enrollment ID: I20080828000343 |
| Provider Name | Robert Jason Kellett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134159171 PECOS PAC ID: 3476595323 Enrollment ID: I20090811000098 |
| Provider Name | Ashley Wiggins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427080902 PECOS PAC ID: 1456483338 Enrollment ID: I20100712000433 |
| Provider Name | Deborah J Grate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205890670 PECOS PAC ID: 5991984353 Enrollment ID: I20110201000365 |
| Provider Name | David S Bridges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598720112 PECOS PAC ID: 8426238817 Enrollment ID: I20110201000805 |
| Provider Name | Jason D Dahlberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508800848 PECOS PAC ID: 8729083787 Enrollment ID: I20110228000231 |
| Provider Name | Veronica L Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942593827 PECOS PAC ID: 9335313337 Enrollment ID: I20111130000510 |
| Provider Name | Casie Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528408051 PECOS PAC ID: 9830315506 Enrollment ID: I20140801001594 |
| Provider Name | Billie J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396162517 PECOS PAC ID: 2062632276 Enrollment ID: I20141009001232 |
| Provider Name | Jo L Hammett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871994327 PECOS PAC ID: 0749502854 Enrollment ID: I20141126001945 |
| Provider Name | Elcy Zimik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538397658 PECOS PAC ID: 7517287261 Enrollment ID: I20150520000171 |
| 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 W Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205203502 PECOS PAC ID: 1759689094 Enrollment ID: I20160419002960 |
| Provider Name | Chanelle C Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629510862 PECOS PAC ID: 5496031569 Enrollment ID: I20170405000041 |
| Provider Name | Joseph Krakowiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518316041 PECOS PAC ID: 4082982566 Enrollment ID: I20170626001759 |
| Provider Name | Rachel Mantooth Griggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720576192 PECOS PAC ID: 0143576223 Enrollment ID: I20180703000216 |
| Provider Name | Sarah Rudder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437780053 PECOS PAC ID: 3779912159 Enrollment ID: I20200406003115 |
| Provider Name | Casey Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770019507 PECOS PAC ID: 7315378379 Enrollment ID: I20200507002877 |
| Provider Name | Amy R Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467019943 PECOS PAC ID: 5294156626 Enrollment ID: I20200610001922 |
| Provider Name | Elizabeth Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346869948 PECOS PAC ID: 7416376744 Enrollment ID: I20201006000643 |
| Provider Name | Amanda Ellenburg Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679165419 PECOS PAC ID: 6800296443 Enrollment ID: I20210617003058 |
| Provider Name | Parker Edison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477013746 PECOS PAC ID: 3870823545 Enrollment ID: I20220826001866 |
| Provider Name | John B Beasley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033776588 PECOS PAC ID: 4082008529 Enrollment ID: I20221007000021 |
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