TARA ANN CANCELLARO


Address: 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593
Phone: 8644545115

TARA ANN CANCELLARO (NPI# 1215969167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215969167
Entity Type Individual
Full Name TARA ANN CANCELLARO
Credential MD
Practice Address 200 Patewood Dr
Suite A200
Greenville
SC 29615-3593
Mailing Address 1 Independence Pt
Suite 212
Greenville
SC 29615-4545
Practice Telephone 8644545115
Mailing Telephone 8647976311
Enumeration Date 2006-07-07
Last Update Date 2015-11-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0006X Pediatrics
Specialization: Developmental – Behavioral Pediatrics
23347 SC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC T75335 05

Office Location

Street Address 200 PATEWOOD DR
SUITE A200
City GREENVILLE
State SC
Zip Code 29615-3593

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508861345 John Kim Johnson Neurological Surgery 200 Patewood Dr, Suite B260, Greenville, SC 29615-3593 2005-06-17
1255941241 Sharmaine Barnes Specialist/Technologist 200 Patewood Dr, Greenville, SC 29615-3593 2020-08-04
1598320897 Yana Ginzburg Physical Therapist 200 Patewood Dr, Greenville, SC 29615-3593 2019-05-02
1457891228 Sierra R Williams Nurse Practitioner 200 Patewood Dr, Suite B260, Greenville, SC 29615-3593 2017-02-27
1063951333 Megan Lee Hiott Nurse Practitioner 200 Patewood Dr, A330, Greenville, SC 29615-3593 2017-02-19
1316485394 Anita Suzette Combs Nurse Practitioner 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 2017-02-09
1730626813 Lauren Lee Hays Nurse Practitioner 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 2017-01-26
1497200083 Abigail Pellett Physical Therapist 200 Patewood Dr, Ste C150, Greenville, SC 29615-3593 2016-08-24
1033664909 Prisma Health-upstate General Acute Care Hospital 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 2016-08-22
1144775032 Prisma Health-upstate General Acute Care Hospital 200 Patewood Dr, Building A, Greenville, SC 29615-3593 2016-08-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194358051 Adenike Orogade Behavior Technician 17 Caldedon Ct, Suite B, Greenville, SC 29615 2020-02-19
1629608369 Jennifer Jacobsen Behavior Technician 17 Caldedon Court, Suite B, Greenville, SC 29615 2020-01-22
1932668217 Carolina Orthopaedic and Neurosurgical Associates Orthopaedic Surgery Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 2019-03-18
1255816070 Trevis L Cureton Pharmacist 2401 East North St, Greenville, SC 29615 2018-09-27
1497232565 Jacob J Fountain Nurse Practitioner 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 2018-07-23
1346726924 St. Francis Physician Services, Inc Internal Medicine 5 Hoke Smith Blvd, Greenville, SC 29615 2018-07-17
1558853101 Alexandra Michelle Taylor Audiologist 200 Patewood Dr Ste 400, Greenville, SC 29615 2018-05-30
1316466543 Mariah Hope Mosher Behavioral Analyst 7 Mckenna Commons Court, Greenvilee, SC 29615 2017-09-19
1326400896 Karen L Heaps Counselor 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 2016-03-24
1134589013 Sharon Erk Technician, Other 2950 E.norths St, Greenville, OH 29615 2016-03-04
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Taxonomy Information

Taxonomy Code 2080P0006X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Developmental – Behavioral Pediatrics

Taxonomy Definition

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518917061 Rae Lynne Hornsby Pediatrics 142 Milestone Way, Greenville, SC 29615-5065 2006-05-12
1841644077 Sara Elizabeth Lilly Pediatrics 701 Grove Rd Fl 5, Greenville, SC 29605-4210 2016-04-13
1477872810 Caroline Black Buchanan Pediatrics 14 Edgewood Dr, Greenville, SC 29605-4246 2010-05-25
1578890273 Prisma Health University Medical Group Pediatrics 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 2009-11-17
1831318856 Greenwood Genetics Center, Inc. Pediatrics 14 Edgewood Dr, Greenville, SC 29605-4246 2007-04-25
1154474385 Alfred Quinn Scheuer Pediatrics 925 Conference Dr, Greenville, NC 27858-5971 2007-01-19
1710042387 Susan Downer Foreman Pediatrics 925 Conference Dr, Greenville, NC 27858-5971 2006-12-26
1841399599 Luis F. Marti-calzamilia Pediatrics 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 2006-09-21
1295787844 Desmond Peyton Kelly Pediatrics 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 2006-05-16
1093765497 James Harold Beard Jr. Pediatrics 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 2006-05-10
Find all providers in GREENVILLE

Competitor

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City GREENVILLE
Zip Code 29615

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Dataset Information

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.

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