NPIMap

Individual provider Active NPI

Gregory R Pfeninger, PA C

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1295704906
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2032 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 724-2450
NPI assigned
Mar 15, 2006
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2032 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other practice location 1

1160 Van Voorhis Rd
Morgantown, WV 26505
Phone (304) 598-1122

Other identifiers 6

IdentifierTypeStateIssuer
Q22014OtherCARELINK
1840PAMedicaidSC
198177OtherFEDERAL BLACK LUNG
WV322OtherTHE HEALTH PLAN
124508400OtherDEPT OF LABOR WORK COMP
P00178506OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140512000191 SC Practitioner - Physician Assistant 7012983968 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Hospital IncGroup PAC ID 8426958919, 66 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113

416 Robertson Blvd
Suite B
Walterboro, SC 29488-2952
Phone (843) 782-4608

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2032SCMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital Inc. CurrentSince Feb 12, 2014 Accepting new patients
Roper St Francis Hospital-Berkeley Inc. CurrentSince Feb 27, 2025 Accepting new patients
Roper Hospital Inc. CurrentSince Feb 12, 2014 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Feb 10, 2025 Accepting new patients
Bon Secours St. Francis Xavier Hosptial, Inc. CurrentSince Feb 10, 2025 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 10, 2025 Accepting new patients
Russell Biundo MD Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

8536 Palmetto Commerce Pkwy
Ste 501
Ladson, SC 29456
Phone (843) 203-2260

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

100 Callen Blvd
Summerville, SC 29486
Phone (845) 529-3165

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Interoperability endpoints

  • Direct secure messaging: gpfeninger1251892@direct.bsmhealth.org

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1295704906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-724-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1160 Van Voorhis Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "26505",
            "country_code": "US",
            "telephone_number": "304-598-1122",
            "fax_number": "304-598-1124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFENINGER",
        "first_name": "GREGORY",
        "middle_name": "R",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "Q22014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1840PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "198177",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE HEALTH PLAN",
            "identifier": "WV322",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORK COMP",
            "identifier": "124508400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00178506",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.