GREENWOOD GENETICS CENTER, INC. (NPI# 1225259039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225259039 |
| Entity Type | Organization |
| Organization Name | GREENWOOD GENETICS CENTER, INC. |
| Practice Address |
1911 Thurmond Mall Columbia SC 29201-2375 |
| Mailing Address |
101 Gregor Mendel Cir Greenwood SC 29646-2316 |
| Practice Telephone | 8037995390 |
| Practice Fax Number | 8037995391 |
| Mailing Telephone | 8643881072 |
| Mailing Fax Number | 8643881052 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-01-29 |
| Authorized Official Name | MRS. DAWN PUDERBAUGH HODGES (ADMINISTRATOR) |
| Authorized Official Telephone | 8649418100 |
| Is Organization Subpart | Y |
| Parent Organization Name | GREENWOOD GENETIC CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 170100000X | Medical Genetics, Ph.D. Medical Genetics | ========= | SC | Other Service Providers |
| 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 |
| 1104013663 | Greenwood Genetics Center, Inc. | Pediatrics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2007-09-28 |
| 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 |
1911 THURMOND MALL |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29201-2375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184615825 | Lola B Clarkson | Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2005-11-02 |
| 1407487416 | Kathryn Teresa Drazba | Genetic Counselor, MS | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2020-01-29 |
| 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 |
| 1093795130 | Ken Corning | Genetic Counselor, MS | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2006-01-17 |
| 1902885023 | Amy Toburen Dobson | Genetic Counselor, MS | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2006-01-17 |
| 1477532505 | Angie Ward Lichty | Genetic Counselor, MS | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049421 | Souzan Moslehshirazi | Behavior Technician | 1320 Main Street Suite 300, Colombia, SC 29201 | 2020-10-02 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1548887128 | Casania's Caring Hands,llc | Home Health Aide | 1113 Belleview Street, 105, Columbia, SC 29201 | 2020-06-30 |
| 1639719909 | Benjamin Clark Watson | Acupuncturist | 1825 Sumter St., Columbia, SC 29201 | 2020-01-14 |
| 1588217574 | Aneika Daley | Specialist/Technologist | 1211 Wheat St, Columbia, SC 29201 | 2019-07-19 |
| 1447803531 | Gillian Taylor Shaughnessy | Specialist/Technologist | 147 South Marion St, Columbia, SC 29201 | 2019-07-18 |
| 1417417619 | Maria Nelson | Behavior Technician | 320 Main St Suite 300, Columbia, SC 29201 | 2019-03-22 |
| 1679041297 | Nathaniel Carl Stocker | Nurse Practitioner | 1614 Main Street, Suite C, Sc House Calls Inc, Columbia, SC 29201 | 2018-11-13 |
| 1558852855 | The Practice | Family Medicine | 1910 Gregg Street, Columbia, SC 29201 | 2018-05-22 |
| 1871095836 | Kadesjah Samuels | Behavior Technician | 1320 Main Street, Suite 300, Columbia, SC 29201 | 2018-03-06 |
| Find all providers in zip 29201 | ||||
| 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 |
|---|---|---|---|---|
| 1376569681 | Kimberly A Martin | Medical Genetics | 1705 E Broadway Ste 300, Columbia, MO 65201-7167 | 2006-07-14 |
| 1477544112 | Randall S Colby | Medical Genetics | 115 Atrium Way, Suite 120, Columbia, SC 29223-6371 | 2005-11-02 |
| 1184615825 | Lola B Clarkson | Medical Genetics | 1911 Thurmond Mall, Columbia, SC 29201-2375 | 2005-11-02 |
| 1386942407 | Ayman W El-hattab | Medical Genetics | 402 N Keene St, Ste 101, Columbia, MO 65201-6986 | 2011-03-14 |
| 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 |
| 1164432720 | Jerome L Gorski | Medical Genetics | 402 N Keene St, Ste 101, Columbia, MO 65201-6986 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922087162 | Barbara L Gordon | Medical Genetics | 101 Gregor Mendel Cir, Greenwood, SC 29646-2316 | 2006-01-16 |
| 1851382642 | Joseph S Geer Jr. | Medical Genetics | 14 Edgewood Dr, Greenville, SC 29605-4246 | 2005-11-02 |
| 1407847296 | Michael J Lyons | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 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 |
| 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 |
| 1598756850 | Sara S Cathey | Medical Genetics | 3520 W Montague Ave Ste 104, North Charleston, SC 29418-6083 | 2005-11-04 |
| 1083605752 | Roger E Stevenson | Medical Genetics | 106 Gregor Mendel Cir, Greenwood, SC 29646-2315 | 2005-11-02 |
| 1528059292 | Steven A Skinner | Medical Genetics | 106 Gregor Mendel Cir, Greenwood, SC 29646-2315 | 2005-11-02 |
| Find all providers with the same taxonomy | ||||
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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.