GREENVILLE CHILDREN'S CLINIC, P.A. (NPI# 1265653109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265653109 |
| Entity Type | Organization |
| Organization Name | GREENVILLE CHILDREN'S CLINIC, P.A. |
| Practice Address |
4211 Joe Ramsey Blvd E Ste 213 Greenville TX 75401-7857 |
| Practice Telephone | 9034087940 |
| Practice Fax Number | 9034087941 |
| Mailing Telephone | 9034087940 |
| Mailing Fax Number | 9034087941 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID K FRY (PRESIDENT) |
| Authorized Official Telephone | 9034087940 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | J2568 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4211 JOE RAMSEY BLVD E STE 213 |
| City | GREENVILLE |
| State | TX |
| Zip Code | 75401-7857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295962918 | Amardeep K Sandhu | Pediatrics | 4211 Joe Ramsey Blvd E Ste 213, Greenville, TX 75401-7857 | 2009-06-20 |
| 1699911149 | Kimberly Diane Bowers | Nurse Practitioner | 4211 Joe Ramsey Blvd E Ste 213, Greenville, TX 75401-7857 | 2009-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653512 | Steven Wolanski | Occupational Therapy Assistant | Greenville Gardens Snf 3500 Park St., Greenville, TX 75401 | 2018-09-18 |
| 1184125460 | Heather Rae Hudson | Registered Nurse | 4911 Henry St, Greenville, TX 75401 | 2018-02-22 |
| 1154864742 | Kimberly Elaine Middleton | Nurse Practitioner | 4211 Joe Ramsey Blvd E Ste 105, Greenville, TX 75401 | 2016-11-30 |
| 1013373885 | Paul Brancheau | Podiatrist | 3900 Joe Ramsey Blvd E Bldg 5, Greenville, TX 75401 | 2016-01-11 |
| 1982079331 | Foresight Home Healthcare Incorporated | Home Health | 2102 Frazier Street, Greenville, TX 75401 | 2015-12-10 |
| 1083018451 | Johnny Sanders Jr. | Nurse's Aide | 1705 Northwest Hwy, Garland, TX 75401 | 2014-10-14 |
| 1942620299 | Robert Chandler Duckworth | Counselor | 4216 Wesley Street, Suite 700, Greenville, TX 75401 | 2014-04-24 |
| 1164843645 | Erica Rae Crawford | Psychologist | 3101 Joe Ramsey Boulevard, Suite 103a, Greenville, TX 75401 | 2013-12-30 |
| 1215225057 | Jordan Kelsi Mahan | Nurse Practitioner | 4101 Wesley St Ste D, Greenville, TX 75401 | 2011-07-14 |
| 1477888196 | Johnny Johnson | Physician Assistant | 4211 Joe Ramsey Blvd, Suite 100, Greenville, TX 75401 | 2009-10-14 |
| Find all providers in zip 75401 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609380278 | Sarah Rider Grubbs | Pediatrics | 58 Park Vista Way, Greenville, SC 29617-7939 | 2017-11-18 |
| 1679005409 | Shailesh Manandhar | Pediatrics | 2816 Holly Glen Dr Apt A, Greenville, NC 27834-0064 | 2017-03-30 |
| 1114377645 | Madison Leigh Merritt | Pediatrics | 415 Duncan Chapel Rd, Greenville, SC 29617-8224 | 2016-06-15 |
| 1699139089 | Hunter Utkov Altman | Pediatrics | 701 Grove Road/ob Residency, Greenville, SC 29605-4210 | 2016-04-11 |
| 1851771976 | Ranjith Kasanagottu | Pediatrics | 200 Patewood Dr # A, Greenville, SC 29615-3593 | 2015-06-03 |
| 1336551365 | Sarah Rose Mangum Needham | Pediatrics | 709 Chesapeake Pl, Greenville, NC 27858-6236 | 2014-05-26 |
| 1124466164 | Katherine Marie Richardson | Pediatrics | 200 Patewood Drive Suite A200, Greenville, SC 29615-3580 | 2013-06-12 |
| 1689916264 | Shannon Nicole James | Pediatrics | 703 Verdae Blvd, Greenville, SC 29607 | 2013-03-21 |
| 1346411592 | Smithfield Pediatrics | Pediatrics | 7 Smith Avenue, Suite 103, Greenville, RI 02828 | 2008-03-16 |
| 1558546366 | Childrens Community Care | Pediatrics | 90 Shenango St Ste 12, Greenville, PA 16125-2060 | 2007-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 75401 |
Please comment or provide details below to improve the information on GREENVILLE CHILDREN'S CLINIC, P.A..
| 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.