GREENWOOD GENETICS CENTER, INC. (NPI# 1104013663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104013663 |
| Entity Type | Organization |
| Organization Name | GREENWOOD GENETICS CENTER, INC. |
| Practice Address |
3520 W Montague Ave Ste 104 North Charleston SC 29418-6083 |
| Mailing Address |
101 Gregor Mendel Cir Greenwood SC 29646-2316 |
| Practice Telephone | 8437461001 |
| Practice Fax Number | 8438461002 |
| Mailing Telephone | 8643881072 |
| Mailing Fax Number | 8643881052 |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2020-01-29 |
| Authorized Official Name | MRS. DAWN PUDERBAUGH HODGES (ADMINISTRATOR) |
| Authorized Official Telephone | 8649418100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PA2005 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649261462 | Greenwood Genetics Center, Inc. | Pediatrics | 106 Gregor Mendel Cir, Greenwood, SC 29646-2315 | 2005-11-01 |
| 1225259039 | Greenwood Genetics Center, Inc. | Medical Genetics, Ph.D. Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2007-05-01 |
| 1043431851 | Greenwood Genetics Center, Inc. | Medical Genetics, Ph.D. Medical Genetics | 805 Pamplico Hwy, Florence, SC 29505-6047 | 2007-05-01 |
| 1831318856 | Greenwood Genetics Center, Inc. | Pediatrics | 14 Edgewood Dr, Greenville, SC 29605-4246 | 2007-04-25 |
| Street Address |
3520 W MONTAGUE AVE STE 104 |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29418-6083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407847296 | Michael J Lyons | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-02 |
| 1598756850 | Sara S Cathey | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-04 |
| 1669463220 | Richard J Schroer | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710529235 | Safe Keeping Healthcare LLC | Home Health | 2850 Ashley Phoshate Rd Suite J, Charleston, SC 29418 | 2019-10-16 |
| 1487136180 | Aston J Rosenberg | Speech-Language Pathologist | 4362 Leslie St, North Charleston, SC 29418 | 2018-08-30 |
| 1285178996 | Aaron Brown | Counselor | 5060 Dorchester Road, Suite 200, North Charleston, SC 29418 | 2016-12-14 |
| 1003265828 | Health Edge Laser LLC | Chiropractor | 4965 Centre Pointe Dr. Suite 100, North Charleston, SC 29418 | 2016-06-13 |
| 1568866481 | Rickey Ciapha Dennis Sr. | Social Worker | 108 Knightsbridge Drive, North Charleston, SC 29418 | 2014-10-21 |
| 1780086330 | Stephanie Washington | Specialist | 5060 Drochester Rd, North Charleston, SC 29418 | 2014-09-25 |
| 1043631369 | Julian H. Campbell, Dmd PC | Dentist | 3188 W. Montague Ave, North Charleston, SC 29418 | 2014-01-05 |
| 1750660676 | Marie's Home Care | Home Health | 7610 Mcknight St., Apt.a, North Charleston, SC 29418 | 2011-08-09 |
| 1437437548 | Trident General Dentistry, Douglas S Rawls, Dm | Dentist | 6335 Dorchester Road, North Carleston, SC 29418 | 2011-07-25 |
| 1508165291 | Patrick Michael Looser | Internal Medicine | 4969 Centre Pointe Dr Ste 100, North Charleston, SC 29418 | 2011-03-21 |
| Find all providers in zip 29418 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407847296 | Michael J Lyons | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-02 |
| 1598756850 | Sara S Cathey | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-04 |
| 1669463220 | Richard J Schroer | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922087162 | Barbara L Gordon | Medical Genetics | 101 Gregor Mendel Cir, Greenwood, SC 29646-2316 | 2006-01-16 |
| 1477544112 | Randall S Colby | Medical Genetics | 115 Atrium Way, Suite 120, Columbia, SC 29223-6371 | 2005-11-02 |
| 1851382642 | Joseph S Geer Jr. | Medical Genetics | 14 Edgewood Dr, Greenville, SC 29605-4246 | 2005-11-02 |
| 1184615825 | Lola B Clarkson | Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2005-11-02 |
| 1447246673 | Steven Dennis Shapiro | Medical Genetics | 1483 Tobias Gadson Blvd, Ste 102, Charleston, SC 29407-8702 | 2005-09-22 |
| 1619255445 | Swetha Krishnamurthi | Medical Genetics | 101 Gregor Mendel Cir, Greenwood, SC 29646-2316 | 2011-07-27 |
| 1649488164 | Yuri A Zarate | Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2007-05-18 |
| 1164518494 | Eloise J. Prijoles | Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2006-10-05 |
| 1306954268 | Gurpur Shashidhar Pai | Medical Genetics | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-08-29 |
| 1972554897 | Neena L. Champaigne | Medical Genetics | 106 Gregor Mendel Cir, Greenwood, SC 29646-2315 | 2006-05-15 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29418 |
Please comment or provide details below to improve the information on GREENWOOD GENETICS CENTER, INC..
| 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.