Kurt L Gandenberger, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14391 Issued in SC

Practice address

6704 White Horse Rd
Greenville, SC 29611-2504

Phone

(864) 294-1392

Fax

(864) 294-0424

NPI assigned

May 31, 2006

Last updated

Sep 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Doctors Care, PA

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1366499048
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1386681526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-782-4278",
            "fax_number": "803-782-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6704 WHITE HORSE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296112504",
            "telephone_number": "864-294-1392",
            "fax_number": "864-294-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDENBERGER",
        "first_name": "KURT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "14391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14391",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catina Johnson Kamdem Gamo
• Brigitte Gamrat, PA
• Jin Mei Gams, NP-C
• Scott Christopher Gams, PT
• Sophia Ganahl
• Sagar S Gandhi, MD
• Bashia Nicole Gandy, LDO
• Sydney Gandy
• Paige Katherine Ganem, DO
• Pallavi Ganesan

• Family Medicine Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.