Active NPI
Sylvia Goodman Iwenofu, PA
- Physician Assistant
- Lexington, SC
National Provider Identifier
1578806014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1913
- Practice address
- 118 River Bridge LN
Lexington, SC 29073-9779 - Phone
- (843) 861-4342
- NPI assigned
- Apr 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1913 | SC | Primary |
Addresses
Primary practice location
118 River Bridge LN
Lexington, SC 29073-9779
Mailing address
212 N Warren St
Timmonsville, SC 29161-1446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1578806014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 N WARREN ST",
"city": "TIMMONSVILLE",
"state": "SC",
"postal_code": "291611446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 RIVER BRIDGE LN",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290739779",
"telephone_number": "843-861-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWENOFU",
"first_name": "SYLVIA",
"middle_name": "GOODMAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-03",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "1913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.