Ballentine Pediatrics, LLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

19500 Issued in SC

Legal business name

BALLENTINE PEDIATRICS, LLC

Practice address

11134 Broad River Rd
Suite D
Irmo, SC 29063-9668

Phone

(803) 732-0920

Fax

(803) 227-2759

NPI assigned

Aug 4, 2008

Last updated

Aug 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deanne Nicola Geurkink, MDNPI 1407867351

Title

Owner/Provider

Phone

(803) 732-0920

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12379/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deanne N Geurkink, MD

  • Pediatric Adolescent Medicine Physician
  • Irmo, SC
  • NPI 1407867351
  NPD (past) Authorized official
• Kelly Clark

  • Nurse Practitioner
  • Irmo, SC
  • NPI 1639840580
  NPD (past)
• Karen P Pollock, M.D.

  • Pediatric Adolescent Medicine Physician
  • Irmo, SC
  • NPI 1023162286
  NPD (past)

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1629234141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11134 BROAD RIVER RD",
            "address_2": "SUITE D",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290639668",
            "telephone_number": "803-732-0920",
            "fax_number": "803-227-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 BROAD RIVER RD",
            "address_2": "SUITE D",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290639668",
            "telephone_number": "803-732-0920",
            "fax_number": "803-227-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLENTINE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "GEURKINK",
        "authorized_official_first_name": "DEANNE",
        "authorized_official_middle_name": "NICOLA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "803-732-0920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "SC",
            "license": "19500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195005",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Bailey, RN
• Stephen Lee Bailey, PT, DPT
• Christian Baker, M.D.
• Rick Baldwin
• Kellie Anne Balko, OTR/L
• Ballentine Rehabilitation & Wellness
• Kesler Ballew
• Alyssa Cajka Banks
• Corrine Lea Barbian, L.P.C.
• Olivia Barker

• Pediatric Adolescent Medicine Physician in Irmo, SC
• Providers in Irmo, SC by specialty
• Pediatric Adolescent Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.