DR. MARC TARO ISHIZUKA (NPI# 1023230844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023230844 |
| Entity Type | Individual |
| Full Name | DR. MARC TARO ISHIZUKA |
| Credential | D.O. |
| Practice Address |
41 Park Creek Dr Va Outpatient Clinic In Greenville Greenville SC 29605-4270 |
| Practice Telephone | 8642991600 |
| Mailing Telephone | 8642991600 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
2012-01291 | SC | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
25MB08244700 | NJ | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
OT010508 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
41 PARK CREEK DR VA OUTPATIENT CLINIC IN GREENVILLE |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548243264 | April Keen | Nutritionist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2005-11-28 |
| 1508464991 | Ashley Popham | Physical Therapist | 41 Park Creek Dr, Greenville, SC 29605-2960 | 2020-10-16 |
| 1285241745 | Nathan Andrew Hogue | Social Worker | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2020-09-29 |
| 1598370769 | Anna Blythe Bottino | Nurse Practitioner | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2020-09-14 |
| 1578101242 | Jamie Nagle | Dental Hygienist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-12-12 |
| 1265086953 | Kirstie Brooke Jackson | Licensed Practical Nurse | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-07-31 |
| 1275192874 | Maggie Estelle Asman | Student in an Organized Health Care Education/Training Program | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-06-07 |
| 1205494580 | Tandi Gilmore | Nurse Practitioner | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-06-03 |
| 1194288670 | Haminah Laverne Johnson | Social Worker | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-04-10 |
| 1578057600 | Elora Ommen | Optometrist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2018-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518591858 | Awakenings Psychiatric Services, PC | Psychiatry & Neurology | 1010 E North St Ste 1a, Greenville, SC 29601-3166 | 2020-02-25 |
| 1386192540 | Arc Psychiatry LLC | Psychiatry & Neurology | 96 Villa Rd, Greenville, SC 29615-3052 | 2016-09-16 |
| 1467863506 | Allison Mcdade | Psychiatry & Neurology | 2710 Sunset Strip Ste D, Greenville, TX 75402 | 2014-05-12 |
| 1457681025 | Woodlands Medical Clinic Pa | Psychiatry & Neurology | 155 Brozzini Ct, Suite E, Greenville, SC 29615-5340 | 2010-01-05 |
| 1235367822 | Elizabeth Jo Mason | Psychiatry & Neurology | 200 Patewood Dr Ste A100, Greenville, SC 29615 | 2009-06-23 |
| 1972730166 | Raza H. Sayed Md, Pa | Psychiatry & Neurology | 301east Division St, Greenville, TX 75401-4101 | 2009-06-16 |
| 1972738458 | Lance Feldman | Psychiatry & Neurology | 10 Patewood Dr, Suite 130, Greenville, SC 29615-6317 | 2009-05-27 |
| 1497989842 | The Family Wellness Center Pllc | Psychiatry & Neurology | 1025b Director Ct, Greenville, NC 27858-5996 | 2009-05-13 |
| 1699975102 | Nadyah Janine John | Psychiatry & Neurology | 905 Johns Hopkins Dr., Ecu Physicians Psychiatric Medicine, Greenville, NC 27834-7225 | 2007-07-23 |
| 1295930964 | Poinsett Psychiatric Group | Psychiatry & Neurology | 3c Cleveland Ct, Greenville, SC 29607-2414 | 2007-06-20 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.