| Three Rivers Medical Associates, Pa | |
|
7430 College St Irmo SC 29063-2903 | |
| (839) 200-7510 | |
| (803) 891-7085 |
| Full Name | Three Rivers Medical Associates, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 7430 College St, Irmo, South Carolina |
| Authorized Official Name and Position | John Gould (PRESIDENT) |
| Authorized Official Contact | 8392007510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Three Rivers Medical Associates, Pa 7430 College St Irmo SC 29063-2903 Ph: (839) 200-7510 | Three Rivers Medical Associates, Pa 7430 College St Irmo SC 29063-2903 Ph: (839) 200-7510 |
| NPI Number | 1760445597 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 01/12/2022 |
| Medicare PECOS PAC ID | 1557267663 |
|---|---|
| Medicare Enrollment ID | O20031210000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760445597 | NPI | - | NPPES |
| CB9366 | Other | SC | RAILROAD MEDICARE |
| GP1314 | Medicaid | SC |
| Provider Name | John Gould |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215922091 PECOS PAC ID: 0345221297 Enrollment ID: I20040526000986 |
| Provider Name | Dana M Nairn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801843529 PECOS PAC ID: 1850362237 Enrollment ID: I20040802000610 |
| Provider Name | David Keith Bridgers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982696829 PECOS PAC ID: 9931176070 Enrollment ID: I20040916000747 |
| Provider Name | Tasha M Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699745141 PECOS PAC ID: 1254360803 Enrollment ID: I20050804000639 |
| Provider Name | Leroy J Huffman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881689032 PECOS PAC ID: 0840283644 Enrollment ID: I20051005000912 |
| Provider Name | Melissa Hess Hummel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255398426 PECOS PAC ID: 2163437617 Enrollment ID: I20060220000602 |
| Provider Name | Kaoru Joan Pridgen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790755353 PECOS PAC ID: 9032126990 Enrollment ID: I20060317000163 |
| Provider Name | Gayle Lynn Brook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902987407 PECOS PAC ID: 3577552835 Enrollment ID: I20080312000018 |
| Provider Name | Christopher Buckingham Ballou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659400943 PECOS PAC ID: 9335291863 Enrollment ID: I20090715000135 |
| Provider Name | Louis Hite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265434013 PECOS PAC ID: 1658364450 Enrollment ID: I20101215000472 |
| Provider Name | Peggy V Toliver-dingle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477545325 PECOS PAC ID: 1557354354 Enrollment ID: I20101215000617 |
| Provider Name | Holly L Grooms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114226792 PECOS PAC ID: 4688843485 Enrollment ID: I20110812000089 |
| Provider Name | Hailey L Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770954026 PECOS PAC ID: 5991007320 Enrollment ID: I20151231001153 |
| Provider Name | Chelsea Diane Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952877599 PECOS PAC ID: 0345585147 Enrollment ID: I20181226001338 |
| Provider Name | Rachel Elizabeth Yaghi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205484250 PECOS PAC ID: 5597191734 Enrollment ID: I20200205003058 |
| Provider Name | Leah M Bagley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962030809 PECOS PAC ID: 2466874706 Enrollment ID: I20210519002376 |
| Provider Name | Jessica C Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760154447 PECOS PAC ID: 8022400415 Enrollment ID: I20220114001507 |
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