CONWAY PEDIATRICS,PA (NPI# 1518986637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518986637 |
| Entity Type | Organization |
| Organization Name | CONWAY PEDIATRICS,PA |
| Practice Address |
907 Bell St Conway SC 29526-4113 |
| Practice Telephone | 8432482727 |
| Practice Fax Number | 8432485107 |
| Mailing Telephone | 8432482727 |
| Mailing Fax Number | 8432485107 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-02-20 |
| Authorized Official Name | DR. THOMAS PETRUSICK (DOCTOR) |
| Authorized Official Telephone | 8432482727 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 4548 | SC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RHC063 | 05 |
| Street Address |
907 BELL ST |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-4113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639255078 | Thea S Collin | Nurse Practitioner | 907 Bell St, Conway, SC 29526-4113 | 2006-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548459597 | Coastal Family Medicine | Legal Medicine | 8014 Myrtle Trace Dr, Conway, SC 29526-8945 | 2007-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174903009 | Lions Den Recreation Center, The | Legal Medicine | 4159 Dorchester Rd, Suite B, North Charleston, SC 29405-7426 | 2015-06-05 |
| 1245666015 | R Dale Padgett Md Pa | Legal Medicine | 3750 I Savannah Highway, Johns Island, SC 29455-7909 | 2013-09-24 |
| 1548692478 | Advantage Medical Group, LLC | Legal Medicine | 9153 Two Notch Rd Ste C, Columbia, SC 29223-5853 | 2013-08-02 |
| 1750540795 | Midlands Mediation & Associates LLC | Legal Medicine | 5716 Weston Ave, Suite B, Columbia, SC 29203-4643 | 2008-06-05 |
| 1750399242 | James Earl Simmons | Legal Medicine | 1875 N Paris Ave, Port Royal, SC 29935-2029 | 2006-08-03 |
| 1023042306 | Robert James Tretola | Legal Medicine | 1933 Tara Trl, Lancaster, SC 29720-8502 | 2006-07-10 |
| 1508814047 | Joe D Hendrix Sr. | Legal Medicine | 1557 Carolina Ave, Orangeburg, SC 29115 | 2006-05-05 |
| 1922076413 | Internal Medicine of Eastside Greer | Legal Medicine | 554 Memorial Drive Ext, Ste B, Greer, SC 29651-1155 | 2006-03-09 |
| 1225028806 | Kimberly M Devolld | Legal Medicine | 2051 Charlie Hall Blvd, Charleston, SC 29414 | 2005-10-25 |
| 1225025158 | Ralph Haygood Johns | Legal Medicine | 451a E Saint John St, Spartanburg, SC 29302-1623 | 2005-10-05 |
| 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.