Individual provider Active NPI

Dorenda Gregg Truesdale, M.D.

  • Family Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1457378309
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22650 Issued in SC
Practice address
2633 Celanese Rd
Rock Hill, SC 29732-1205
Phone
(803) 329-5131
Fax
(803) 366-6600
NPI assigned
Jul 16, 2006
Last updated
Nov 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22650 SC Primary
Family Medicine Physician 207Q00000X 2006-00615 NC

Addresses

Primary practice location

2633 Celanese Rd
Rock Hill, SC 29732-1205

Mailing address

704 Gold Hill Rd
Ste 107
Fort Mill, SC 29715-8907
Phone (803) 329-5131

Other identifiers 3

IdentifierTypeStateIssuer
066NXOtherNCBLUE CROSS BLUE SHIELD NC
080195108OtherRAILROAD MEDICARE
226507MedicaidSC

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
I20111201000581 SC Practitioner - Family Practice 0749387041 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-00615NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Family Medicine CurrentSince Aug 14, 2017 Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health Family Medicine CurrentSince Aug 14, 2017 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
Anmed Health Family Medicine CurrentSince Aug 26, 2019 Accepting new patients
Shiland Family Medicine Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc PastSince Mar 3, 2011 Accepting new patients

Locations

600 N Fant St
Anderson, SC 29621
Phone (864) 512-1787

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

16 Roberts Blvd
Williamston, SC 29697
Phone (864) 512-5800

Interoperability endpoints

  • Direct secure messaging: dtruesdale28230@direct.anmedhealth.net

Organizations & group practices 7

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1457378309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 GOLD HILL RD",
            "address_2": "STE 107",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158907",
            "telephone_number": "803-329-5131",
            "fax_number": "803-366-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 CELANESE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321205",
            "telephone_number": "803-329-5131",
            "fax_number": "803-366-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUESDALE",
        "first_name": "DORENDA",
        "middle_name": "GREGG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22650",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2006-00615",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "066NX",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080195108",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226507",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.