JEFFREY RYAN WIENKE


Address: 1210 W Faris Rd, Greenville, SC 29605-4444
Phone: 8642954410

JEFFREY RYAN WIENKE (NPI# 1558313494) 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) 1558313494
Entity Type Individual
Full Name JEFFREY RYAN WIENKE
Credential MD
Practice Address 1210 W Faris Rd
Greenville
SC 29605-4444
Mailing Address 1 Independence Pt Ste 212
Greenville
SC 29615-4536
Practice Telephone 8642954410
Practice Fax Number 8642955694
Mailing Telephone 8647976303
Enumeration Date 2006-05-17
Last Update Date 2018-01-25
NPI Deactivation Date 07/17/2007
NPI Reactivation Date 2008-03-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
28690 SC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC RAILROAD MEDICARE P00826283 01
SC 286906 05

Other Providers JEFFREY WIENKE

NPI Name Taxonomy Address Enumeration
1629207261 Jeffrey C Wienke Jr. Podiatrist 1150 N 83rd St, Lincoln, NE 68505-2094 2009-07-03

Office Location

Street Address 1210 W FARIS RD
City GREENVILLE
State SC
Zip Code 29605-4444

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508865510 Blake Christopher Poleynard Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2005-07-20
1821584228 Gregory Randal Bryant Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2018-07-09
1235685330 Prisma Health-upstate Clinic/Center 1210 W Faris Rd, Greenville, SC 29605-4444 2016-08-29
1962816058 Michael Knipfing Family Medicine 1210 W Faris Rd, Greenville, SC 29605-4444 2014-06-17
1356755573 Samuel Douglas Volin Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2014-06-16
1891105896 Sanjay Hasmukhlal Mahatma Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2014-04-30
1750729273 Gregory Scott Matthews Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2013-06-06
1790028868 Richard Christopher Leach Radiology 1210 W Faris Rd, Greenville, SC 29605-4444 2013-03-27
1689920464 Pavani Thotakura Shah Internal Medicine 1210 W Faris Rd, Greenville, SC 29605 2012-07-30
1750642096 Todd Michael Danziger Radiology 1210 W Faris Rd, Greenville, SC 29605 2012-06-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205306099 Prisma Health University Medical Group Family Medicine 110 Osage Drive, Greenville, SC 29605 2018-12-05
1306325626 Lauren Foster Fiscus Occupational Therapist 1900 Augusta Street, Suite 2500, Greenville, SC 29605 2018-08-08
1063914372 Harris Teeter LLC Durable Medical Equipment & Medical Supplies 1720 Augusta St, Greenville, SC 29605 2018-03-02
1144748385 Johanna Ruth Henry Speech-Language Pathologist 1900 Augusta St., Suite 2500, Greenville, SC 29605 2017-09-08
1477083483 Alexis Dean Pedigo Speech-Language Pathologist 1900 Augusta St, Suite 2500, Greenville, SC 29605 2017-06-13
1134658420 Trace Christopher Deighan Obstetrics & Gynecology 890 West Faris Road, Suite 470, Greenville, SC 29605 2017-06-08
1023569837 Blessed With Goodness, LLC In Home Supportive Care 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 2016-10-17
1972050953 Suha Umina Pharmacist 975 W. Faris Road, Greenville, SC 29605 2016-09-07
1124470976 Meredith Laine Cavagrotti Specialist/Technologist 700 Grove Rd, Greenville, SC 29605 2016-07-05
1205286895 Med-trans Corporation Ambulance 552 Perimeter Rd, Greenville, SC 29605 2016-06-15
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417423088 Bon Secours Diagnostic Imaging Radiology 1 Marcus Dr Ste 100, Greenville, SC 29615-4818 2018-10-22
1700352374 Bon Secours Diagnostic Imaging Radiology 2 Innovation Dr Ste 350, Greenville, SC 29607-5269 2018-10-22
1710292313 Eastern Radiologist Inc Radiology 2090a W Arlington Blvd, Greenville, NC 27834-5727 2010-08-09
1790002822 Gd Radiology Pa Radiology 4215 Joe Ramsy Blvd, Greenville, TX 75401-7852 2010-04-29
1497998934 Comanche County Hospital Authority Southwest Radiology Radiology 101 Babbs Holw, Greenville, SC 29607-3745 2009-04-14
1235324476 Mchenry Peters Jr. Radiology 110 Windward Rd, Greenville, DE 19807-2436 2007-09-11
1679775001 Molecular Imaging Assoc Pllc Radiology 136 Fioranelli Dr, Greenville, MS 38701-7313 2007-06-05
1730258831 Robert P Oliver Radiology 5 Orchard Pl, Greenville, MS 38701-8079 2006-11-06
1043321920 Donald S Prior Radiology 1654 S Colorado St, Greenville, MS 38703-7216 2006-08-31
1295759223 Charles E Parke Radiology 105 Holbrook Trail, Greenville, SC 29605-3164 2006-07-26
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Competitor

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City GREENVILLE
Zip Code 29605

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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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