DOMINIC JOHNSON (NPI# 1720308851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720308851 |
| Entity Type | Individual |
| Full Name | DOMINIC JOHNSON |
| Credential | M.D. |
| Practice Address |
877 W Faris Rd Ste B Greenville SC 29605 |
| Mailing Address |
877 W Faris Rd Ste B Greenville SC 29605-4296 |
| Practice Telephone | 8644556993 |
| Mailing Telephone | 8644556993 |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 37108 | SC | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
37108 | SC | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD37108 | SC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696453 | Dominic Robert Johnson | Behavior Technician | 1001 Sneath Ln Ste 200, San Bruno, CA 94066-2349 | 2020-07-20 |
| 1851858302 | Dominic C Johnson | Nurse's Aide | 2575 Westgate Bldg 2, Pendleton, OR 97801-9613 | 2019-02-20 |
| 1104393149 | Dominic Idris Johnson | Behavioral Analyst | 150 Glen Cove Marina Rd E Ste 102, Vallejo, CA 94591-7237 | 2018-10-29 |
| 1952314353 | Dominic A Johnson | Emergency Medicine | 736 Battlefield Blvd N, Chesapeake General Hospital, Chesapeake, VA 23320-4941 | 2006-08-15 |
| Street Address |
877 W FARIS RD STE B |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588640643 | Archie Hortense Chandler IIi | Internal Medicine | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2005-12-21 |
| 1740893593 | Timothy Robert Malinowski Jr. | Nurse Practitioner | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2020-08-30 |
| 1043841646 | Jordan Gaucher | Physician Assistant | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2020-02-01 |
| 1386274397 | Serena Wormald Kocourek | Registered Nurse | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2020-01-17 |
| 1366097230 | Megan Diane Mcguire | Nurse Practitioner | 877 W Faris Rd Ste B, Greenville, SC 29605 | 2019-08-07 |
| 1295210961 | Katherine Armstrong Sorrel | Physician Assistant | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2018-09-28 |
| 1750893277 | Kimberly Elliott Sadri | Registered Nurse | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2017-10-25 |
| 1467976720 | Whitney Kendall Fields | Nurse Practitioner | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2017-07-28 |
| 1255792206 | Anna Elizabeth Calk | Nurse Practitioner | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2016-03-17 |
| 1457718918 | Elizabeth Peters | Nurse Practitioner | 877 W Faris Rd Ste B, Greenville, SC 29605-4296 | 2016-01-28 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657663 | Cardiosleep Diagnostics | Internal Medicine | 1862 Old Fort Rd, Greenville, NC 27834-9373 | 2020-04-06 |
| 1760770333 | Gregory Harris | Internal Medicine | 2340 Hemby Ln Ste 100, Greenville, NC 27834-3792 | 2011-07-18 |
| 1457641466 | Christopher French | Internal Medicine | 4211 Joe Ramsey Blvd E Ste 108, Greenville, TX 75401-7858 | 2011-04-11 |
| 1528225356 | Matthew B Sellers | Internal Medicine | 2 Innovation Dr., Ste. 400, Greenville, SC 29607-5270 | 2008-05-20 |
| 1093822421 | Lee A. Surkin | Internal Medicine | 2459 Emerald Pl Ste 102, Greenville, NC 27834-5739 | 2006-08-23 |
| 1992716732 | Kenneth A Hahn | Internal Medicine | 1306 Hospital St, Greenville, MS 38703-3215 | 2006-08-10 |
| 1578582441 | Cynthia Lynn Kues | Internal Medicine | 404 Durley St, Greenville, IL 62246-1504 | 2006-07-19 |
| 1326077058 | Michael Mansour | Internal Medicine | 1315 E Union St, Greenville, MS 38703-3245 | 2006-07-03 |
| 1427094432 | Kathleen Anne Mansour | Internal Medicine | 1513 E Union St, Greenville, MS 38703-3249 | 2006-06-20 |
| 1952364200 | James L Young Jr. | Internal Medicine | 14 Edgewood Drive, Greenville, SC 29605 | 2006-04-08 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.