Individual provider Active NPI

Geetika Dembla, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Greer, SC
National Provider Identifier
1164626875
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
204062 Issued in LA
Practice address
2700 E Phillips Rd
Greer, SC 29650-4815
Phone
(864) 235-2335
NPI assigned
Jun 14, 2007
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 204062 LA
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 204062 LA Primary

Addresses

Primary practice location

2700 E Phillips Rd
Greer, SC 29650-4815

Mailing address

2700 E Phillips Rd
Greer, SC 29650-4815
Phone (864) 235-2335

Other identifiers 2

IdentifierTypeStateIssuer
2126857MedicaidLA
4P643F600OtherLAMEDICACRE - PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180515000509 SC Practitioner - Psychiatry 1456548890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Mississippi School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

124 Mallard St
Greenville, SC 29601-4046
Phone (864) 241-1040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
204062LAMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 15, 2019 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 15, 2019 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients

Locations

124 Mallard St
Greenville, SC 29601
Phone (864) 241-1040

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1164626875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E PHILLIPS RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504815",
            "telephone_number": "864-235-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E PHILLIPS RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504815",
            "telephone_number": "864-235-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBLA",
        "first_name": "GEETIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "204062",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "LA",
            "license": "204062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2126857",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICACRE - PTAN",
            "identifier": "4P643F600",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.