Greenwood Genetics Center, Inc.

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

Legal business name

GREENWOOD GENETICS CENTER, INC.

Practice address

3520 W Montague Ave Ste 104
North Charleston, SC 29418-6083

Phone

(843) 746-1001

Fax

(843) 846-1002

NPI assigned

Sep 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Pridmore

Title

Coo

Phone

(864) 941-8100

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Florence, SC
  • NPI 1043431851

  O20031226000075

  Same enrollment
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Columbia, SC
  • NPI 1225259039

  O20031226000075

  Same enrollment
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Greenwood, SC
  • NPI 1649261462

  O20031226000075

  Same enrollment
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Greenville, SC
  • NPI 1831318856

  O20031226000075

  Same enrollment

Tax ID family

Greenwood Genetic Cente5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Greenwood Genetic Center Lab

  • Clinical Medical Laboratory
  • Greenwood, SC
  • NPI 1669463014
  NPD tax ID
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Florence, SC
  • NPI 1043431851
  NPD tax ID
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Columbia, SC
  • NPI 1225259039
  NPD tax ID
• Greenwood Genetics Center, Inc.

  • Clinical Genetics (M.D.) Physician
  • Greenville, SC
  • NPI 1831318856
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Devereaux Buch, PA

  • Medical Physician Assistant
  • Greenville, SC
  • NPI 1346801164
  NPD
• Lola B Clarkson, MD

  • Clinical Genetics (M.D.) Physician
  • Columbia, SC
  • NPI 1184615825
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1104013663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462316",
            "telephone_number": "864-388-1072",
            "fax_number": "864-388-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W MONTAGUE AVE STE 104",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294186083",
            "telephone_number": "843-746-1001",
            "fax_number": "843-846-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD GENETICS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "PRIDMORE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "864-941-8100"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA2005",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy Greenberg, APRN, CNM
• Brittany Greene, M.ED., LPC
• Christina Greene, RN
• Cortlan Robert Greenhalgh, PT, DPT
• Danielle Greenman, ATC
• Stephen Greenwood, HEALTH TECH
• Jamie Greer, RN
• Mikalah Greer
• Louann Gregory
• Haley Christine Griffith

• Clinical Genetics (M.D.) Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Clinical Genetics (M.D.) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.