JANET M MCKISSICK (NPI# 1407878366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407878366 |
| Entity Type | Individual |
| Full Name | JANET M MCKISSICK |
| Credential | MD |
| Practice Address |
333 Revolutionary Trl Fairfax SC 29827-7109 |
| Mailing Address |
86 Wren St Barnwell SC 29812-1529 |
| Practice Telephone | 8036322533 |
| Practice Fax Number | 8036322451 |
| Mailing Telephone | 8032595762 |
| Mailing Fax Number | 8032593250 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2017-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 13979 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 139790 | 05 |
| Street Address |
333 REVOLUTIONARY TRL |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033160254 | Baxter Mclendon | Specialist | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-05-12 |
| 1851656243 | Wanda W Tutt | Dietitian, Registered | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2012-07-11 |
| 1649414905 | Walter R Kirby | Physician Assistant | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2009-04-29 |
| 1104979061 | Delois Daniels | Nurse Practitioner | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2007-01-22 |
| 1164516209 | Bobbie Franklin Ayers Jr. | Family Medicine | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-10-03 |
| 1538170121 | Lucille Miley Sanders | Nurse Practitioner | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-08-10 |
| 1003820531 | Richard Boyles | Family Medicine | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1588815021 | James Robert Mynatt | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2008-10-02 |
| 1063607646 | Mol Ky | General Practice | 333 Revolutionary Trail, Fairfax, SC 29827 | 2007-09-07 |
| 1053475566 | Low Country Health Care System, Inc | Pharmacy | 333 Revolutionary Trail, Farifax, SC 29827 | 2006-12-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922561943 | Tammy Jones Md Pllc | Family Medicine | 9683 Main St Ste A, Fairfax, VA 22031-3755 | 2019-04-08 |
| 1194209544 | Aramcare, LLC | Family Medicine | 11230 Waples Mill Rd Ste 125, Fairfax, VA 22030-6002 | 2018-09-21 |
| 1881112902 | Cheryl Anne Arenella | Family Medicine | 11150 Fairfax Blvd Ste 200, Fairfax, VA 22030-5066 | 2017-09-08 |
| 1720448442 | Integrated Wellness Md, LLC | Family Medicine | 8316 Arlington Blvd Ste 206, Fairfax, VA 22031-5216 | 2016-02-24 |
| 1255710554 | Kristin Adelle Harrington | Family Medicine | 10530 Rosehaven St Ste 100, Fairfax, VA 22030-2888 | 2015-05-20 |
| 1194111641 | Stephanie Singh | Family Medicine | 3998 Fair Ridge Dr Ste 125, Fairfax, VA 22033-2908 | 2015-04-11 |
| 1811208028 | Hanna Yoon | Family Medicine | 3650 Joseph Siewick Dr Ste 400, Fairfax, VA 22033-1715 | 2010-06-23 |
| 1285879981 | Sabeen Pervaiz | Family Medicine | 4041 University Dr Ste 405, Fairfax, VA 22030-3410 | 2008-12-09 |
| 1164685103 | Carolyn E. Snarskis | Family Medicine | 3650 Joseph Siewick Dr., Suite 400, Fairfax, VA 22033 | 2008-07-09 |
| 1952583650 | Phyllis Jean Drew | Family Medicine | 9683-a Main Street, Fairfax, VA 22031-3755 | 2007-12-04 |
| Find all providers in FAIRFAX | ||||
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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.