CAROLINA RADIATION MEDICINE, PA (NPI# 1053315093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053315093 |
Entity Type | Organization |
Organization Name | CAROLINA RADIATION MEDICINE, PA |
Practice Address |
801 W H Smith Blvd Greenville NC 27834-3764 |
Practice Telephone | 2523290025 |
Practice Fax Number | 2523290325 |
Mailing Telephone | 2523290025 |
Mailing Fax Number | 2523290325 |
Enumeration Date | 2005-06-08 |
Last Update Date | 2008-07-18 |
Authorized Official Name | GORDON GARY KOLTIS (PRESIDENT) |
Authorized Official Telephone | 2523290025 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | TRICARE | 118170 | 01 |
NC | UNITED HEALTHCARE | 24-00059 | 01 |
NC | BCBS | 010SK | 01 |
NC | 89010SK | 05 |
Street Address |
801 W H SMITH BLVD |
City | GREENVILLE |
State | NC |
Zip Code | 27834-3764 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508860545 | Gordon Gary Koltis | Radiology | 801 W H Smith Blvd, Greenville, NC 27834-3764 | 2005-06-08 |
1497750756 | Ron R Allison | Radiology | 801 W H Smith Blvd, Greenville, NC 27834-3764 | 2005-06-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
Find all providers in zip 27834 |
Taxonomy Code | 261QR0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568981843 | Medical Imaging Express | Clinic/Center | 361 Woodruff Rd, Greenville, SC 29607-3415 | 2017-09-18 |
1750311767 | Greenville Physcians Imaging Center | Clinic/Center | 103 S Venture Dr, Greenville, SC 29615-3571 | 2006-07-04 |
1235685330 | Prisma Health-upstate | Clinic/Center | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2016-08-29 |
1720471618 | Emergency Physician Services | Clinic/Center | 2498 N Pleasantburg Dr, Greenville, SC 29609-2730 | 2015-03-17 |
1174795850 | Michigan Medical Patient Care | Clinic/Center | 1202 W Oak St, Greenville, MI 48838-2155 | 2008-04-02 |
1023057502 | Greenville Hospital System | Clinic/Center | 200 Patewood Dr, Suite A16, Greenville, SC 29615-3593 | 2006-06-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306344577 | Union Medical Services, LLC | Clinic/Center | 103 Stanly Pkwy Ste E, Locust, NC 28097-7711 | 2018-01-23 |
1417298134 | Columbus Regional Diagnostics | Clinic/Center | 619 Jefferson St., Ste. 2, Whiteville, NC 28472-3707 | 2013-03-05 |
1043593395 | Waccamaw Ultrasound & Diagnostics | Clinic/Center | 112 E White Oak St, Lake Waccamaw, NC 28450-2128 | 2011-09-22 |
1912192006 | Advanced Imaging, Inc. | Clinic/Center | 406 Thompson St, Eden, NC 27288-5044 | 2007-09-11 |
1124123104 | Sonography Services Inc | Clinic/Center | 125 Wamsutta Mill Rd, Suite B, Morganton, NC 28655-5522 | 2006-09-14 |
1164527149 | Sonocare, LLC | Clinic/Center | 125 B Wamsutta Mill Rd., Morganton, NC 28655 | 2006-09-14 |
1447290010 | Coastal Carolina Health Care Pa | Clinic/Center | 1030 Medical Park Ave, New Bern, NC 28562-5248 | 2006-06-08 |
1588611677 | Sunset Imaging, LLC | Clinic/Center | 850 Sunset Blvd N, Sunset Beach, NC 28468-4262 | 2006-05-27 |
1740231984 | Foundation Health Systems Corp | Clinic/Center | 1701 S Hawthorne Rd, Winston-salem, NC 27103-4015 | 2006-05-12 |
1881239093 | Southeast Radiology Associates Pllc | Clinic/Center | 10926 David Taylor Dr Ste 120, Charlotte, NC 28262-1042 | 2019-11-12 |
Find all providers with the same taxonomy |
City | GREENVILLE |
Zip Code | 27834 |
Please comment or provide details below to improve the information on CAROLINA RADIATION MEDICINE, PA.
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.