ANDREA M PEZZELLA (NPI# 1730157058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730157058 |
| Entity Type | Individual |
| Full Name | ANDREA M PEZZELLA |
| Credential | MD |
| Practice Address |
115 Midlands Ct West Columbia SC 29169-3456 |
| Mailing Address |
109 Midlands Ct Suite A West Columbia SC 29169-3456 |
| Practice Telephone | 8034577000 |
| Practice Fax Number | 8034577001 |
| Mailing Telephone | 8034577000 |
| Mailing Fax Number | 8034577001 |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2017-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 29701 | SC | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 204555 | MA | Allopathic & Osteopathic Physicians |
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
29701 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0120961 | 05 | |
| ONE HEALTH PLAN | 042472266 | 01 | |
| RAILROAD MEDICARE | 160049837 | 01 | |
| HEALTHY START | 37554 | 01 | |
| MEDICARE B | A31235 | 01 | |
| HARVARD PILGRIM HEALTH CA | AA3715 | 01 | |
| BLUE CARE ELECT | J22633 | 01 | |
| PRIVATE HEALTHCARE SYSTEM | 042472266 | 01 | |
| MEDICAID WELFARE | 0120961 | 01 | |
| TRICARE CHAMPUS | 042472266 | 01 | |
| AETNA US HEALTHCARE | 7099315 | 01 | |
| MVP HEALTH CARE | 784225 | 01 | |
| THREE RIVERS | 042472266 | 01 | |
| EVERCARE | 0700410 | 01 | |
| CIGNA HEALTH PLAN | 1009200 | 01 | |
| BLUE SHIELD HMO BLUE | J22633 | 01 | |
| FALLON COMMUNITY HEALTH P | 45822 | 01 | |
| BLUE SHIELD INDEMNITY | J22633 | 01 |
| Street Address |
115 MIDLANDS CT |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-3456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922130830 | Wendy O Walker | Advanced Practice Midwife | 115 Midlands Ct, West Columbia, SC 29169-3456 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366496465 | Paul Christopher Browne | Obstetrics & Gynecology | 222 E Medical Ln Ste 300, West Columbia, SC 29169-4848 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215598230 | Elite Gynecology | Obstetrics & Gynecology | 163 Lake Murray Ter, Lexington, SC 29072-9103 | 2019-06-21 |
| 1295392132 | Venus Gynecology, LLC | Obstetrics & Gynecology | 8203 Nigels Dr Ste 203, Myrtle Beach, SC 29572-4179 | 2019-05-28 |
| 1801285036 | Roper Saint Francis Physicians Network | Obstetrics & Gynecology | 8950 University Blvd, Suite 150, North Charleston, SC 29406 | 2015-01-12 |
| 1447656517 | Donald Richard Hanscom | Obstetrics & Gynecology | 20 Spring Island Dr, Okatie, SC 29909-4006 | 2014-11-17 |
| 1851633028 | Giles Martin Schanen I | Obstetrics & Gynecology | 205 Glen Abbey Way, Greer, SC 29650-3289 | 2013-03-26 |
| 1225373830 | Alan F Korhammer | Obstetrics & Gynecology | 24 Oak Island Rd, Saint Helena Island, SC 29920-3808 | 2012-12-07 |
| 1326316803 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 90 Summit Centre Dr, Columbia, SC 29229-6926 | 2011-12-12 |
| 1528290251 | Baptist Easley Hospital | Obstetrics & Gynecology | 112 John St Ste 103, Easley, SC 29640-1405 | 2009-08-13 |
| 1386880672 | Juliet Chhay Bishop | Obstetrics & Gynecology | 2 Medical Park Rd Ll9/10, Columbia, SC 29203-6839 | 2008-12-17 |
| 1073776118 | Eduardo Goquiolay Arellano | Obstetrics & Gynecology | 9 Bayley Rd, Bluffton, SC 29910-4928 | 2008-07-09 |
| Find all providers with the same taxonomy | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.