| Eau Claire Cooperative Health Center, Inc. | |
|
1228 Harden St Columbia SC 29204-1800 | |
| (803) 733-5969 | |
| (803) 753-5591 |
| Full Name | Eau Claire Cooperative Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1228 Harden St, Columbia, South Carolina |
| Authorized Official Name and Position | Delgado Cantave (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eau Claire Cooperative Health Center, Inc. Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | Eau Claire Cooperative Health Center, Inc. 1228 Harden St Columbia SC 29204-1800 Ph: (803) 733-5969 |
| NPI Number | 1346249430 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 02/03/2022 |
| Certification Date | 02/03/2022 |
| Medicare PECOS PAC ID | 3274434220 |
|---|---|
| Medicare Enrollment ID | O20040114000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346249430 | NPI | - | NPPES |
| FQC031 | Medicaid | SC | |
| CBP018 | Medicaid | SC | |
| 4350 | Other | SC | PALMETTO GBA |
| Provider Name | Subhaschandra Jaynarayan Patel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891771804 PECOS PAC ID: 4789577669 Enrollment ID: I20040205000239 |
| Provider Name | Earnestine B Williams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1871934695 PECOS PAC ID: 5496649899 Enrollment ID: I20040209000290 |
| Provider Name | Kadijah Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518988294 PECOS PAC ID: 0648254292 Enrollment ID: I20040614000541 |
| Provider Name | Ada D Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750333050 PECOS PAC ID: 8426032335 Enrollment ID: I20040617000559 |
| Provider Name | Jody D Ellison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891745980 PECOS PAC ID: 1557349545 Enrollment ID: I20040707001208 |
| Provider Name | Deborah J Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598737678 PECOS PAC ID: 3476525965 Enrollment ID: I20040806000041 |
| Provider Name | Dwayne Aubrey Jacobus |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295726172 PECOS PAC ID: 4082686647 Enrollment ID: I20040816000075 |
| Provider Name | Janet L Douglass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417929134 PECOS PAC ID: 5890756621 Enrollment ID: I20041025000412 |
| Provider Name | Kathleen Elaine Heer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770567802 PECOS PAC ID: 4284603705 Enrollment ID: I20041109000032 |
| Provider Name | Uday K Doppalapudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679599237 PECOS PAC ID: 5395703862 Enrollment ID: I20041230000095 |
| Provider Name | Kimberly Hightower |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144220559 PECOS PAC ID: 0143278820 Enrollment ID: I20050110000529 |
| Provider Name | Dean A Floyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386605285 PECOS PAC ID: 9436100138 Enrollment ID: I20050209000758 |
| Provider Name | Carol B Alan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932116217 PECOS PAC ID: 0648225698 Enrollment ID: I20050314000283 |
| Provider Name | Woodrow A Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659366524 PECOS PAC ID: 2567409642 Enrollment ID: I20050415000688 |
| Provider Name | Timothy S Shaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275598674 PECOS PAC ID: 4284661869 Enrollment ID: I20050726000274 |
| Provider Name | Anthony B Elkins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629045505 PECOS PAC ID: 2961416276 Enrollment ID: I20060125000915 |
| Provider Name | Adelero Olayinka Adebajo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013089572 PECOS PAC ID: 9739194960 Enrollment ID: I20060209000323 |
| Provider Name | Jandrette A Rhoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972691889 PECOS PAC ID: 8325055643 Enrollment ID: I20060313000044 |
| Provider Name | Gail R Dillard-washington |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447201249 PECOS PAC ID: 7911914775 Enrollment ID: I20060320000415 |
| Provider Name | Ernest A Alleyne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396782983 PECOS PAC ID: 5193724862 Enrollment ID: I20061206000241 |
| Provider Name | Marilee C Griswold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821068719 PECOS PAC ID: 2668578667 Enrollment ID: I20070508000684 |
| Provider Name | Kathleen M Moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841265824 PECOS PAC ID: 1658455647 Enrollment ID: I20080229000161 |
| Provider Name | Elizabeth M Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104866771 PECOS PAC ID: 8022197409 Enrollment ID: I20080509000600 |
| Provider Name | Odette D Fisher-glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053398792 PECOS PAC ID: 9931272259 Enrollment ID: I20080721000237 |
| Provider Name | Sarah M Thompson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265641419 PECOS PAC ID: 3577616655 Enrollment ID: I20090807000013 |
| Provider Name | Jennifer Fouquette Fisher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730242108 PECOS PAC ID: 5597810937 Enrollment ID: I20090908000491 |
| Provider Name | Carol A Heebner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548239064 PECOS PAC ID: 6406999754 Enrollment ID: I20100209000096 |
| Provider Name | Jennifer K Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669400032 PECOS PAC ID: 4082669171 Enrollment ID: I20100602000665 |
| Provider Name | Ezra M Ash-malachi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477746469 PECOS PAC ID: 0547394306 Enrollment ID: I20100816000229 |
| Provider Name | Nita Thapa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730315839 PECOS PAC ID: 5597945147 Enrollment ID: I20110214000915 |
| Provider Name | Trenten Aristotle Prioleau |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104129790 PECOS PAC ID: 4981887783 Enrollment ID: I20110331000170 |
| Provider Name | Prishal Chetty Holloway |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104025782 PECOS PAC ID: 9133304736 Enrollment ID: I20110426000150 |
| Provider Name | Joseph P Grant |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639135239 PECOS PAC ID: 3072790385 Enrollment ID: I20110712000543 |
| Provider Name | Danny Charles Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467413682 PECOS PAC ID: 8921999756 Enrollment ID: I20110722000038 |
| Provider Name | Charlie Wofford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609031400 PECOS PAC ID: 8628247731 Enrollment ID: I20110805000795 |
| Provider Name | Eric M Schlueter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629020037 PECOS PAC ID: 2769669597 Enrollment ID: I20110908002003 |
| Provider Name | Aboagye Agyenim-boateng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194758243 PECOS PAC ID: 0547363889 Enrollment ID: I20110908002282 |
| Provider Name | Dean R Jacobs |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427034040 PECOS PAC ID: 6507827813 Enrollment ID: I20120109000519 |
| Provider Name | Ugichi Cantave |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720219256 PECOS PAC ID: 5092975813 Enrollment ID: I20120330000647 |
| Provider Name | Linda Crout Wingard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669432779 PECOS PAC ID: 1658533419 Enrollment ID: I20120424000679 |
| Provider Name | Wanda D Gibson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659453918 PECOS PAC ID: 2163678228 Enrollment ID: I20120807000006 |
| Provider Name | Monica S Mccutcheon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144482035 PECOS PAC ID: 6709032865 Enrollment ID: I20120807000011 |
| Provider Name | Julie L Brasher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982951000 PECOS PAC ID: 1557511532 Enrollment ID: I20121029000452 |
| Provider Name | Sharrell Tonya Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033453048 PECOS PAC ID: 6507013612 Enrollment ID: I20130625000495 |
| Provider Name | Crystal Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831431931 PECOS PAC ID: 8921248659 Enrollment ID: I20130701000378 |
| Provider Name | Shawnequa Latrina Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437280906 PECOS PAC ID: 6709951098 Enrollment ID: I20130710000350 |
| Provider Name | Elizabeth Wagoner Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861798845 PECOS PAC ID: 5193968915 Enrollment ID: I20130827000382 |
| Provider Name | Augustus Rodgers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588613517 PECOS PAC ID: 1355437609 Enrollment ID: I20131002000585 |
| Provider Name | Carryn N Rice |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679697452 PECOS PAC ID: 1759515729 Enrollment ID: I20131004000444 |
| Provider Name | Tabitha Jones Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144502444 PECOS PAC ID: 1355570318 Enrollment ID: I20140215000042 |
| Provider Name | Janee Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699101584 PECOS PAC ID: 2567694987 Enrollment ID: I20140416001951 |
| Provider Name | Ever Shamiel Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700125879 PECOS PAC ID: 0345463634 Enrollment ID: I20140513001281 |
| Provider Name | Ruby Albert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295721009 PECOS PAC ID: 3870717200 Enrollment ID: I20140605000052 |
| Provider Name | Vernica Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215260435 PECOS PAC ID: 1456572072 Enrollment ID: I20141024000830 |
| Provider Name | Chermaine Latrice Lyde |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689830226 PECOS PAC ID: 8527289032 Enrollment ID: I20141027002299 |
| Provider Name | Rosa M Castillo Schilder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588093728 PECOS PAC ID: 0941523286 Enrollment ID: I20141217002843 |
| Provider Name | Morgan Jackson Kanwisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134520836 PECOS PAC ID: 6002139144 Enrollment ID: I20141223000009 |
| Provider Name | Emmeline L Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760868962 PECOS PAC ID: 6002125333 Enrollment ID: I20151027001613 |
| Provider Name | Lindsay M Hall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1831573625 PECOS PAC ID: 3779883541 Enrollment ID: I20151201000047 |
| Provider Name | Allison Murrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851762694 PECOS PAC ID: 7113228131 Enrollment ID: I20151216002773 |
| Provider Name | La'kia Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326411448 PECOS PAC ID: 6608179023 Enrollment ID: I20160119002096 |
| Provider Name | Katherine J Atkinson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407042476 PECOS PAC ID: 6800190778 Enrollment ID: I20160212002139 |
| Provider Name | Rebecca Biscoglia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780829465 PECOS PAC ID: 5193020980 Enrollment ID: I20160216001015 |
| Provider Name | Rebecca L White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447223433 PECOS PAC ID: 2062471568 Enrollment ID: I20160302000431 |
| Provider Name | Danielle R Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639328743 PECOS PAC ID: 0840594008 Enrollment ID: I20160302000719 |
| Provider Name | Ashton Shealy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710362827 PECOS PAC ID: 9032415427 Enrollment ID: I20160310001820 |
| Provider Name | Dan R Bodison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215937610 PECOS PAC ID: 4789981572 Enrollment ID: I20160322001331 |
| Provider Name | Jeanine Khoury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740201417 PECOS PAC ID: 8325339443 Enrollment ID: I20160621001752 |
| Provider Name | Stephanie Gibson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124356399 PECOS PAC ID: 0143512038 Enrollment ID: I20160713002236 |
| Provider Name | Meredith Brazell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073952909 PECOS PAC ID: 2466694500 Enrollment ID: I20160808000235 |
| Provider Name | Lynn L Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740264290 PECOS PAC ID: 0345536868 Enrollment ID: I20160909001632 |
| Provider Name | Elizabeth Winfield Derks |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1912453267 PECOS PAC ID: 1456649342 Enrollment ID: I20161010000186 |
| Provider Name | April E Barnes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194163832 PECOS PAC ID: 3577852987 Enrollment ID: I20161010001396 |
| Provider Name | Tamika Bryson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164874558 PECOS PAC ID: 9234427964 Enrollment ID: I20161013000620 |
| Provider Name | Alicia K Ribar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679680631 PECOS PAC ID: 7618937434 Enrollment ID: I20161018000991 |
| Provider Name | Louquis P Canty Belk |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1902859135 PECOS PAC ID: 4284915653 Enrollment ID: I20161222000747 |
| Provider Name | Allison Stroughton Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013369453 PECOS PAC ID: 5991089286 Enrollment ID: I20170306001444 |
| Provider Name | Amanda Driggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972042505 PECOS PAC ID: 4183901838 Enrollment ID: I20170505000045 |
| Provider Name | Carolyn Brown |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942470448 PECOS PAC ID: 3678840782 Enrollment ID: I20170522000222 |
| Provider Name | Shanda Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114468832 PECOS PAC ID: 8527335124 Enrollment ID: I20170602001477 |
| Provider Name | Tracie Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306376199 PECOS PAC ID: 5092088088 Enrollment ID: I20170914000171 |
| Provider Name | Keionda C Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487185484 PECOS PAC ID: 2466728829 Enrollment ID: I20171030003024 |
| Provider Name | Kelly Niermeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861855645 PECOS PAC ID: 0446516025 Enrollment ID: I20171115000699 |
| Provider Name | Melissa Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285160325 PECOS PAC ID: 4284993726 Enrollment ID: I20180109001423 |
| Provider Name | Sabrina Blocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922510353 PECOS PAC ID: 3173882628 Enrollment ID: I20180109002049 |
| Provider Name | Alexandra B Weathersby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851790216 PECOS PAC ID: 9830414168 Enrollment ID: I20180228002516 |
| Provider Name | Jason A Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841747417 PECOS PAC ID: 7113204603 Enrollment ID: I20180412001959 |
| Provider Name | Jordan Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194222935 PECOS PAC ID: 0446515274 Enrollment ID: I20180529002190 |
| Provider Name | Tonia Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811496862 PECOS PAC ID: 6204181670 Enrollment ID: I20180626002982 |
| Provider Name | Jessica Newell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184123630 PECOS PAC ID: 2365790888 Enrollment ID: I20180731002283 |
| Provider Name | Latova Nichelle Quattlebaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659854255 PECOS PAC ID: 3072857101 Enrollment ID: I20181130001131 |
| Provider Name | Heather Schneider Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952874158 PECOS PAC ID: 3173857752 Enrollment ID: I20190702001402 |
| Provider Name | Jared Williams Atkinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629424114 PECOS PAC ID: 4587955893 Enrollment ID: I20190703000287 |
| Provider Name | Whitney Lynn Shepard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285013276 PECOS PAC ID: 0547551939 Enrollment ID: I20190916001205 |
| Provider Name | Amber A Flanigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215443106 PECOS PAC ID: 7113359506 Enrollment ID: I20191125001010 |
| Provider Name | Jamilya A Swygert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942855986 PECOS PAC ID: 7911330022 Enrollment ID: I20191204000037 |
| Provider Name | Shavon Prabhakar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194371500 PECOS PAC ID: 1052747334 Enrollment ID: I20200205000121 |
| Provider Name | Selma Hadziahmetovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609419449 PECOS PAC ID: 8426484734 Enrollment ID: I20200205001481 |
| Provider Name | Annette G Burden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891138970 PECOS PAC ID: 0345677811 Enrollment ID: I20200221001179 |
| Provider Name | Melissa B Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871133728 PECOS PAC ID: 1254762537 Enrollment ID: I20200521000881 |
| Provider Name | Milissa P Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558992701 PECOS PAC ID: 9133541873 Enrollment ID: I20200625000591 |
| Provider Name | Angel J Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497394852 PECOS PAC ID: 8022430719 Enrollment ID: I20200625002529 |
| Provider Name | Lisa Creel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164058681 PECOS PAC ID: 5395162051 Enrollment ID: I20200827000231 |
| Provider Name | Amanda Suzanne Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881220226 PECOS PAC ID: 0446670376 Enrollment ID: I20201015000667 |
| Provider Name | Wanda K Fulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881204899 PECOS PAC ID: 8527470962 Enrollment ID: I20201209001451 |
| Provider Name | Kimberly D Smith |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1912120023 PECOS PAC ID: 4385057074 Enrollment ID: I20210129000328 |
| Provider Name | Maureen O Nwajiaku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790321917 PECOS PAC ID: 0840604062 Enrollment ID: I20210129002158 |
| Provider Name | Amber I Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245827369 PECOS PAC ID: 3870909708 Enrollment ID: I20210301002154 |
| Provider Name | Towanna Shanett Lance Enoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982709069 PECOS PAC ID: 1254568355 Enrollment ID: I20210526002470 |
| Provider Name | Brandi Burgess Hair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114542586 PECOS PAC ID: 3779984299 Enrollment ID: I20210622001429 |
| Provider Name | Mary K Weeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689299406 PECOS PAC ID: 1355743311 Enrollment ID: I20210713002675 |
| Provider Name | Morgan D Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427665181 PECOS PAC ID: 9537562293 Enrollment ID: I20210720000321 |
| Provider Name | Veronica L Stukes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457995375 PECOS PAC ID: 2365831559 Enrollment ID: I20211109001969 |
| Provider Name | Candace Marie Gregg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629338389 PECOS PAC ID: 8527450667 Enrollment ID: I20220121000885 |
| Provider Name | John V Ferguson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528157930 PECOS PAC ID: 5991730749 Enrollment ID: I20220208001839 |
| Provider Name | Elizabeth Munn Krouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275205932 PECOS PAC ID: 8325435811 Enrollment ID: I20220502001883 |
| Provider Name | Tiffany L Gethers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386301133 PECOS PAC ID: 9335526268 Enrollment ID: I20220516001729 |
| Provider Name | Arlene Martin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427054717 PECOS PAC ID: 0446636658 Enrollment ID: I20220926001177 |
| Provider Name | Lauren Rudd Nates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689214033 PECOS PAC ID: 9830565415 Enrollment ID: I20221024000376 |
| Provider Name | Latonya Brailsford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003205808 PECOS PAC ID: 0547637258 Enrollment ID: I20221109003523 |
| Provider Name | Isabel Margarita Lemasters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811514961 PECOS PAC ID: 4082081583 Enrollment ID: I20221111000967 |
| Provider Name | Sarah Burnside Riggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104544329 PECOS PAC ID: 3072984483 Enrollment ID: I20230123002210 |
| Provider Name | James Van Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932716172 PECOS PAC ID: 0446621783 Enrollment ID: I20230124000669 |
| Provider Name | Viarda Licelot Polanco Zacarias |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902202096 PECOS PAC ID: 7618349994 Enrollment ID: I20230215000163 |
| Provider Name | Ashley Rene Sikes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538872643 PECOS PAC ID: 0244605780 Enrollment ID: I20230413002956 |
| Provider Name | Kishan V Kumar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639676679 PECOS PAC ID: 7810234994 Enrollment ID: I20230419001633 |
| Provider Name | Shalanda E Pollins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093418683 PECOS PAC ID: 0941668776 Enrollment ID: I20230626003061 |
| Provider Name | Karonda W Hardrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669861738 PECOS PAC ID: 7911351572 Enrollment ID: I20230929003160 |
| Provider Name | Savanah P Querze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235915539 PECOS PAC ID: 9830546530 Enrollment ID: I20231116001957 |
| Provider Name | Jennifer N Ervin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346659372 PECOS PAC ID: 5294182929 Enrollment ID: I20231116003033 |
| Provider Name | Beth M Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609640416 PECOS PAC ID: 2163875378 Enrollment ID: I20240124001402 |
| Provider Name | Shaundra N Pickett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811530546 PECOS PAC ID: 7517310790 Enrollment ID: I20240124003689 |
| Provider Name | Jennifer J Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386068021 PECOS PAC ID: 7810340502 Enrollment ID: I20240130000562 |
| Provider Name | Cindy M Richardson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861788317 PECOS PAC ID: 2860845351 Enrollment ID: I20240131004125 |
| Provider Name | Shaletha L Richard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134522337 PECOS PAC ID: 4082058136 Enrollment ID: I20240216003605 |
| Provider Name | Lamancia Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477161057 PECOS PAC ID: 5496193336 Enrollment ID: I20240410003652 |
Kreative Counseling Enrichment Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 N Beltline Blvd, Columbia, SC 29204 Phone: 803-261-1621 | |
Counseling & Consulting Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Outlet Pointe Blvd, Columbia, SC 29210 Phone: 803-772-6540 Fax: 803-772-6540 | |
Epworth Children's Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2900 Millwood Ave, Columbia, SC 29205 Phone: 803-212-4793 Fax: 803-212-4287 | |
North Carolina Mentor Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Saint Julian Pl Ste 200, Columbia, SC 29204 Phone: 800-388-5150 | |
Latoya Brooks-key, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9600 Two Notch Rd Ste 5, Columbia, SC 29223 Phone: 803-939-6680 | |
Infinite Solutions Counseling And Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Main St Ste 1980, Columbia, SC 29201 Phone: 803-319-0910 Fax: 803-403-0337 | |
Equilibrium Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Gervais St, Ste 150-258, Columbia, SC 29201 Phone: 803-361-3066 Fax: 866-834-4286 |