MRS. PHYLLIS W DOUGLAS (NPI# 1588263461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588263461 |
Entity Type | Individual |
Full Name | MRS. PHYLLIS W DOUGLAS |
Credential | RN, BSN |
Practice Address |
1931 Industrial Park Rd Conway SC 29526-5482 |
Practice Telephone | 8435041084 |
Mailing Telephone | 8435041084 |
Enumeration Date | 2020-10-21 |
Last Update Date | 2020-10-21 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WH0200X |
Registered Nurse Specialization: Home Health |
R28290 | SC | Nursing Service Providers |
Street Address |
1931 INDUSTRIAL PARK RD |
City | CONWAY |
State | SC |
Zip Code | 29526-5482 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629049382 | Jill E Michael | Nurse Practitioner | 1931 Industrial Park Rd, Conway, SC 29526-5645 | 2006-01-31 |
1265045777 | Stefania Serianni | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2020-08-25 |
1427677863 | Amanda Mcdowell | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2020-04-15 |
1881230464 | Debra Todd | Licensed Practical Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-11-19 |
1508401555 | Emily Goad Atkinson | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-11-14 |
1790338614 | Susan B Metallo | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-07-19 |
1376103564 | Jeana Nicole Richardson | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-06-19 |
1124684733 | Debra L. Toomey | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-05-20 |
1982174983 | Kelly Ann Ryder | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2018-12-03 |
1982173209 | Alyssa Gideon | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2018-11-15 |
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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 | 163WH0200X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Home Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801213327 | Tonya Peavy | Registered Nurse | 729 Brown Swamp Rd, Conway, SC 29527-3636 | 2014-03-21 |
1316181670 | Robert Lane Bowen | Registered Nurse | 32 Timothy Ln, Conway, AR 72034-4959 | 2009-04-29 |
1508401555 | Emily Goad Atkinson | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2019-11-14 |
1225457062 | Patricia Michaelis Shuping | Registered Nurse | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2014-04-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932711777 | Alicia Blanding | Registered Nurse | 865 Saint Paul Church Cir, Camden, SC 29020-1647 | 2020-08-22 |
1598394892 | Lawana M Jeter | Registered Nurse | 8 Sycamore Dr Ste B8b, Greenville, SC 29607-2965 | 2020-04-07 |
1295369312 | Diane Martin | Registered Nurse | 1322 W Poinsett St, Greer, SC 29650-1250 | 2020-02-27 |
1629627732 | Amari Williams | Registered Nurse | 1407 Red Oaks Dr, Rock Hill, SC 29730-6598 | 2019-09-11 |
1851946123 | Abundant Life Home Care Services LLC | Registered Nurse | 1565 Ebenezer Rd Ste 112, Rock Hill, SC 29732-3421 | 2019-08-05 |
1205398294 | River Road Care | Registered Nurse | 50 Promise Land Rd, Edgefield, SC 29824-0001 | 2019-04-01 |
1043795560 | Quanisha S Corley | Registered Nurse | 821 N Brickyard Rd, Columbia, SC 29223-8227 | 2018-10-01 |
1285121640 | Linda Reeves Mccullough | Registered Nurse | 1014bwhitehall Rd., Anderson, SC 29625 | 2018-04-20 |
1295233088 | Veronica Anderson | Registered Nurse | 1070 Whitlow Blvd, Summerville, SC 29483-5343 | 2018-01-26 |
1629583554 | Wendy S Fiddler | Registered Nurse | 1092 Johnnie Dodds Blvd Ste 112, Mt Pleasant, SC 29464-6192 | 2017-12-14 |
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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.