Gregory Tarasidis, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

20020 Issued in SC

Practice address

1015 Spring St
Greenwood, SC 29646

Phone

(864) 227-6741

Fax

(864) 227-2026

NPI assigned

Oct 25, 2006

Last updated

Oct 9, 2007By 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Greenwood Ear Nose and Throat Assoc PA

  • Otolaryngology Physician
  • Greenwood, SC
  • NPI 1699839878
  Medicare reassignment NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1588748321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-227-6741",
            "fax_number": "864-227-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-227-6741",
            "fax_number": "864-227-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARASIDIS",
        "first_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "20020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA1122",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synergy Counseling of Greenwood
• Kristin Tackett, OTR/L
• Deandrea Talley-Bowens
• Dantera Tangpisuthipongsa, MD
• Hal Tanner
• Jennifer Brooke Tavernier
• Allison Taylor, PHARMD
• Felicia N Taylor
• Harold A Taylor Jr., PH.D.
• Samuel H Taylor, MD

• Otolaryngology Physician in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Otolaryngology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.