SPARTANBURG MEDICAL CENTER (NPI# 1053724450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053724450 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG MEDICAL CENTER |
| Other Organization Name | MEDICAL GROUP OF THE CAROLINAS - DERMATOLOGY |
| Practice Address |
391 Serpentine Dr Suite 300 Spartanburg SC 29303-3080 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645609716 |
| Practice Fax Number | 8645609715 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-12-09 |
| Authorized Official Name | KENNETH MEINKE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8645606000 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP6482 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Group of the Carolinas - Dermatology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386205094 | Spartanburg Medical Center | Pediatrics | 575 Ingles Dr Ste A, Inman, SC 29349-8314 | 2019-06-24 |
| 1780248211 | Spartanburg Medical Center | Urology | 2755 S Highway 14 Ste 2050a, Greer, SC 29650-4902 | 2019-04-30 |
| 1205499217 | Spartanburg Medical Center | Internal Medicine | 104 Professional Park Ste C, Gaffney, SC 29340-2319 | 2019-04-16 |
| 1649735127 | Spartanburg Medical Center | Family Medicine | 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 | 2019-02-08 |
| 1316416415 | Spartanburg Medical Center | Orthopaedic Surgery | 1650 Skylyn Dr Ste 120, Spartanburg, SC 29307-1069 | 2018-11-19 |
| 1609345982 | Spartanburg Medical Center | Urology | 1552 N Limestone St Ste A, Gaffney, SC 29340-4750 | 2018-11-16 |
| 1316416688 | Spartanburg Medical Center | Internal Medicine | 104 Professional Park Ste B, Gaffney, SC 29340-2319 | 2018-11-16 |
| 1396220554 | Spartanburg Medical Center | Surgery | 840 W Floyd Baker Blvd Ste B, Gaffney, SC 29341-1845 | 2018-10-03 |
| 1114432077 | Spartanburg Medical Center | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200m, Greer, SC 29650 | 2017-12-13 |
| 1518498336 | Spartanburg Medical Center | Family Medicine | 2846 N Old Laurens Rd, Gray Court, SC 29645-3157 | 2017-03-23 |
| Street Address |
391 SERPENTINE DR SUITE 300 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303-3080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061561 | Richard Lee Conn | Surgery | 391 Serpentine Dr, Ste 250, Spartanburg, SC 29303-3080 | 2005-05-23 |
| 1245765841 | Christina L Blake | Registered Nurse | 391 Serpentine Dr, Suite 400, Spartanburg, SC 29303-3096 | 2017-04-21 |
| 1083099857 | Kristin Elena Klimbal | Nurse Practitioner | 391 Serpentine Dr, Suite 400, Spartanburg, SC 29303-3096 | 2015-07-22 |
| 1972997179 | Destiny Moore Moss | Nurse Practitioner | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3096 | 2015-03-25 |
| 1831534486 | John Charles Barnett | Counselor | 391 Serpentine Dr, Suite 400, Spartanburg, SC 29303-3096 | 2013-05-08 |
| 1982948410 | Craig Stephen Williams | Psychologist | 391 Serpentine Dr, Suite 400, Spartanburg, SC 29303-3096 | 2012-11-21 |
| 1912279837 | Nicole Marcantonio Pierce | Social Worker | 391 Serpentine Dr, Spartanburg, SC 29303-3096 | 2012-02-08 |
| 1821226960 | Erin Anderson | Urology | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3096 | 2009-06-28 |
| 1629220132 | The Carolina Hand Center | Durable Medical Equipment & Medical Supplies | 391 Serpentine Dr, Suite 440, Spartanburg, SC 29303-3096 | 2008-10-15 |
| 1558535575 | Christiana Danielle Degregorie | Psychologist | 391 Serpentine Dr, Suite 400, Doctor's Center, Spartanburg, SC 29303-3096 | 2008-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801013719 | Westside Dermatology, LLC | Dermatology | 1410b John B White Sr Blvd, Spartanburg, SC 29306-3927 | 2007-04-20 |
| 1316905631 | Peter J Neidenbach | Dermatology | 1410 B John B White Sr Blvd, Spartanburg, SC 29306-3927 | 2006-05-03 |
| 1821098823 | Karen A Devore | Dermatology | 490 Floyd Rd, Spartanburg, SC 29307-1518 | 2005-08-01 |
| 1285634188 | Beth Camille Del Savio | Dermatology | 2020 N Church Street Pl, Spartanburg, SC 29303-2706 | 2005-07-21 |
| 1255754008 | Advanced Dermatology of Sc PC | Dermatology | 1410b John B White Sr Blvd, Spartanburg, SC 29306-3927 | 2014-01-30 |
| 1326247909 | Blair Wetmore Clementson | Dermatology | 2020 N Church Street Pl, Spartanburg, SC 29303-2706 | 2007-07-13 |
| 1497709067 | Spartanburg Dermatology & Skin Surgery Clinic, PC | Dermatology | 2020 N Church Street Pl, Spartanburg, SC 29303-2706 | 2006-05-19 |
| 1407856305 | Elizabeth S Dunlavey | Dermatology | 2020 N Church Street Pl, Spartanburg, SC 29303-2706 | 2005-07-21 |
| 1487654380 | Aaron Steven Katz | Dermatology | 2020 N Church Street Pl, Spartanburg, SC 29303-2706 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366075343 | Dermatology and Skin Surgery Inc | Dermatology | 325 Broad St Ste 200, Sumter, SC 29150-4167 | 2020-02-18 |
| 1942844667 | Oakview Dermatology | Dermatology | 937 Riverwalk Pkwy Ste 202, Rock Hill, SC 29730-0178 | 2019-11-06 |
| 1427614577 | Georgia Dermatology & Skin Cancer Center, LLC | Dermatology | 2110 Woodside Executive Court, Aiken, SC 29803-3809 | 2019-05-14 |
| 1578038535 | Integrated Dermatology of Hilton Head, LLC | Dermatology | 3901 Main St Ste D, Hilton Head, SC 29926-4613 | 2018-10-05 |
| 1982138715 | Skin Solution To Massage | Dermatology | 1 Chick Springs Rd Ste 207a, Greenville, SC 29609-4976 | 2017-04-19 |
| 1700272978 | Leah Swanson | Dermatology | 135 Rutledge Ave # Msc578, Charleston, SC 29425-8903 | 2015-04-14 |
| 1730596685 | Atlantic Dermatology | Dermatology | 3600 Sea Mountain Hwy Ste A, Little River, SC 29566-8161 | 2014-07-11 |
| 1598179947 | Georgetown Physician Associates, LLC | Dermatology | 4033 Highway 17, Suite 105, Murrells Inlet, SC 29576-5032 | 2014-06-13 |
| 1770996621 | David Mark Perry | Dermatology | 48 Folly Road Blvd, Charleston, SC 29407-7507 | 2014-06-09 |
| 1891106811 | Sarah M. Derrington | Dermatology | 9217 University Blvd., Ste C1b, Charleston, SC 29406 | 2014-05-13 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
Please comment or provide details below to improve the information on SPARTANBURG MEDICAL CENTER.
| 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.