KIMBERLEY LIS BARRACCO (NPI# 1700984366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700984366 |
| Entity Type | Individual |
| Full Name | KIMBERLEY LIS BARRACCO |
| Credential | DO |
| Practice Address |
407 W South St Union SC 29379 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8644298846 |
| Mailing Telephone | 8645604123 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39076 | SC | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 2064 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 7070869 | 01 | |
| SC | MEDICARE PIN | SCC510H895 | 01 |
| WV | 3810005951 | 05 | |
| SC | 390767 | 05 | |
| BLUE CROSS BLUE SHEILD | 001879423 | 01 |
| Street Address |
407 W SOUTH ST |
| City | UNION |
| State | SC |
| Zip Code | 29379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326605635 | Sally Gallman Robinson | Nurse Practitioner | 407 W South St, Union, SC 29379-2771 | 2019-05-22 |
| 1144722919 | Union Medical Center | Clinic/Center | 407 W South St, Union, SC 29379-2771 | 2018-03-07 |
| 1811499890 | Union Medical Center | Pediatrics | 407 W South St, Union, SC 29379 | 2018-03-06 |
| 1356727457 | Spartanburg Medical Center | Nurse Practitioner | 407 W South St, Union, SC 29379-2771 | 2015-07-31 |
| 1659645612 | Mollie L Huskey | Nurse Practitioner | 407 W South St, Union, SC 29379-2771 | 2012-03-07 |
| 1154575579 | Spartanburg Medical Center | Internal Medicine | 407 W South St, Union, SC 29379-2771 | 2008-11-12 |
| 1013103852 | Union Hospital District | Surgery | 407 W South St, Union, SC 29379-2771 | 2007-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780049072 | Dorothy Craig | Social Worker | 201 Herndon, Union, SC 29379 | 2015-12-31 |
| 1588049662 | Spartanburg Medical Center | Internal Medicine | 408 North Duncan By Pass, Suite L, Union, SC 29379 | 2015-07-30 |
| 1891045118 | Crystal Berry Earls | Pharmacist | 109 Beechtree Place, Union, SC 29379 | 2012-09-13 |
| 1871732271 | Union Hospital District Dba Cha Family Medicine | Family Medicine | 801 West Main St, Union, SC 29379 | 2009-02-10 |
| 1336388735 | Union Hospital District | Internal Medicine | 408 N Duncan By Pass, Suite L, Union, SC 29379 | 2009-02-10 |
| 1215185178 | Oakmont of Union Sc LLC | Assisted Living Facility | 709 Rice Street, Union, SC 29379 | 2008-09-04 |
| 1700072444 | Union Hospital District | Obstetrics & Gynecology | 720 South Duncan Bypass, Suite C, Union, SC 29379 | 2007-09-17 |
| 1154449130 | Whitney Connolly Leary | Speech-Language Pathologist | 720 A South Duncan Bypass, Union, SC 29379 | 2007-03-27 |
| 1467577353 | Kathryn Cook Scales | Counselor | 323 W South Street, Union, SC 29379 | 2007-03-20 |
| 1104957901 | Owen K Woolever | Physical Therapist | 720 A S Duncan Bypass, Union, SC 29379 | 2007-03-07 |
| Find all providers in zip 29379 | ||||
| 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 |
|---|---|---|---|---|
| 1902338031 | Dana Reynolds | Pediatrics | 511 Clubhouse Ct, Unit 9, Union, NJ 07083-8778 | 2017-03-29 |
| 1871923342 | Primary Care Partners, LLC | Pediatrics | 1050 Galloping Hill Rd Ste 200, Union, NJ 07083-7980 | 2013-11-20 |
| 1871804328 | Khanh Bao Phan | Pediatrics | 1651 Earl St, Union, NJ 07083-5531 | 2010-06-30 |
| 1255394532 | Robin Michelle Warner | Pediatrics | 8667 Us Highway 42 Ste 300, Union, KY 41091-8759 | 2006-04-08 |
| 1215936604 | Geddy Jay Krul | Pediatrics | 381 Chestnut St, Union, NJ 07083-9430 | 2005-07-18 |
| 1811499890 | Union Medical Center | Pediatrics | 407 W South St, Union, SC 29379 | 2018-03-06 |
| 1154588325 | Union Pediatrics, Psc | Pediatrics | 8667 Us Highway 42 Ste 300, Union, KY 41091-8759 | 2008-05-16 |
| 1336335470 | Patients First Health Care LLC | Pediatrics | 97 Saint Andrews Dr, Union, MO 63084-4946 | 2007-09-21 |
| 1386865772 | Trinity Pediatrics, LLC | Pediatrics | 2333 Morris Ave, Suite B218, Union, NJ 07083-5714 | 2007-05-01 |
| 1275672610 | New Jersey Healthcare Services | Pediatrics | 2780 Morris Ave, Suite 2a, Union, NJ 07083-4852 | 2007-02-05 |
| Find all providers in UNION | ||||
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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.