MS. GLORIA VON ROSSUM LIGHT (NPI# 1821194036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821194036 |
| Entity Type | Individual |
| Full Name | MS. GLORIA VON ROSSUM LIGHT |
| Credential | RN, CPNP |
| Practice Address |
4500 Stuart St Moncrief Army Hospital, Attn: Mcxl-pq (credentials) Columbia SC 29207-5700 |
| Practice Telephone | 8037512689 |
| Mailing Telephone | 8037512689 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
243250 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4500 STUART ST MONCRIEF ARMY HOSPITAL, ATTN: MCXL-PQ (CREDENTIALS) |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29207-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505231 | Christopher Michael Enke | Occupational Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-10-09 |
| 1366071144 | Kaitlin Chrastek | Specialist/Technologist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-04-03 |
| 1316582455 | Melissa Angela Metivier | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-11-13 |
| 1952954695 | Jeriann Sandrik | Optometrist | 4500 Stuart St, Columbia, SC 29207 | 2019-07-22 |
| 1669946455 | Tonya Yvette Parks | Counselor | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-01-15 |
| 1538653795 | Jennifer L Willard | Licensed Practical Nurse | 4500 Stuart St, Columbia, SC 29207-5700 | 2018-06-20 |
| 1114469475 | Carrie Elizabeth Green | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-11-17 |
| 1841640489 | Daniel Greathouse | Optometrist | 4500 Stuart St, 3rd Floor Clinic Wing, Columbia, SC 29207-5700 | 2016-06-14 |
| 1356796205 | Rajesh Devkota | Nurse Practitioner | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-04-28 |
| 1114385770 | Garry Dredge | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
| 1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
| 1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
| 1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
| 1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
| 1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
| 1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
| 1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
| Find all providers in zip 29207 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093225096 | Edna Ayah | Nurse Practitioner | 8310 Guilford Rd, Columbia, MD 21046-1279 | 2017-10-04 |
| 1366995789 | Shawn Danielle Neyens | Nurse Practitioner | 303 N Keene St Ste 404, Columbia, MO 65201-7193 | 2016-08-02 |
| 1962823443 | Erin Gubbins | Nurse Practitioner | 500 N Keene St Ste 303, Columbia, MO 65201-8104 | 2013-12-30 |
| 1386924991 | Eleanor Doris Merboth | Nurse Practitioner | 6100 Dobbin Rd., Columbia, MD 21045 | 2011-08-26 |
| 1902986680 | Penelope Joan Buckman | Nurse Practitioner | 5 Medical Park Road, Columbia, SC 29203 | 2006-10-16 |
| 1952335077 | Karen Mae Waganer | Nurse Practitioner | 2113 Adams Grv Ste 101, Columbia, SC 29203-6957 | 2006-07-11 |
| 1740210129 | Laura L Szadek | Nurse Practitioner | Nine Medical Park, Suite 230, Columbia, SC 29203 | 2006-07-03 |
| 1104866771 | Elizabeth M Berg | Nurse Practitioner | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2006-06-08 |
| 1871546226 | Sara G Fuller | Nurse Practitioner | 2638 Two Notch Rd, Suite 110, Columbia, SC 29204-1454 | 2006-05-18 |
| 1679531859 | Sara Margaret Haslag | Nurse Practitioner | 2011 Corona Rd, Suite 207, Columbia, MO 65203-2548 | 2006-05-03 |
| Find all providers in COLUMBIA | ||||
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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.