CARMINE SUPPA (NPI# 1760800650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760800650 |
| Entity Type | Individual |
| Full Name | CARMINE SUPPA |
| Practice Address |
171 Ashley Ave Charleston SC 29425-3816 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437921414 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2020-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
83194 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
171 ASHLEY AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-3816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203922 | Nicholas J Pastis Jr. | Internal Medicine | 171 Ashley Ave, Charleston, SC 29425-8900 | 2005-05-24 |
| 1760083745 | Eleta Lazar Donelan | Physician Assistant | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-11-05 |
| 1285231340 | Bree Romecki | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-10-02 |
| 1942812078 | Warren Allen James | Student in an Organized Health Care Education/Training Program | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-19 |
| 1457962060 | Rosmary Ros-demarize | Psychologist | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-08-17 |
| 1558971390 | Auryelle Ascue | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-06 |
| 1396361994 | David Gonzalez | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8911 | 2020-06-19 |
| 1003432592 | Hannah Burrick | Audiologist | 171 Ashley Ave, Charleston, SC 29425-8903 | 2020-06-19 |
| 1528683562 | Kelsey Renee Full | Emergency Medicine | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-06-16 |
| 1861017949 | Christina Lee | Anesthesiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154775963 | Jeffrey Lee | Pediatrics | 135 Rutledge Ave # 489b, Charleston, SC 29425 | 2016-04-18 |
| 1578852828 | Nagraj Kasi | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2011-04-06 |
| 1225281124 | University Medical Associates | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| 1063672475 | Candi S Jump | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-06-10 |
| 1346341211 | John N Udall | Pediatrics | 830 Pennsylvania Ave, Suite 103, Charleston, WV 25302 | 2006-09-25 |
| 1205946290 | Janaina Nogueira Anderson | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-1711 | 2006-08-30 |
| 1598726465 | R. Bhanu Vikraman Pillai | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-0100 | 2006-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932177052 | Sudipta Misra | Pediatrics | 295a Midland Pkwy Ste 260, Summerville, SC 29485-9039 | 2006-03-14 |
| 1609851336 | Yuliya Rekhtman | Pediatrics | 14 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6883 | 2005-12-15 |
| 1962994160 | Stormy B Walker | Pediatrics | 3240 Sunset Blvd, West Columbia, SC 29169-3428 | 2018-06-04 |
| 1992146419 | Narendra Yallanki | Pediatrics | 14 Richland Medical Park Dr Ste 310, Columbia, SC 29203 | 2013-07-12 |
| 1649532367 | Lindsay M Moye | Pediatrics | 200 Patewood Dr Ste A140, Greenville, SC 29615 | 2012-06-08 |
| 1942249222 | Jonathan E Markowitz | Pediatrics | 200 Patewood Dr, Suite A140, Greenville, SC 29615-3593 | 2006-06-05 |
| 1568409456 | Douglas E. Winesett | Pediatrics | 200 Patewood Dr, Suite A140, Greenville, SC 29615-3593 | 2006-06-01 |
| City | CHARLESTON |
| Zip Code | 29425 |
Please comment or provide details below to improve the information on CARMINE SUPPA.
| 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.