Dolores Yvonne Tetreault, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

33970 Issued in SC

Practice address

27 Gamecock Ave
Ste 201
Charleston, SC 29407-3398

Phone

(843) 769-8215

Fax

(843) 769-8216

NPI assigned

Jun 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• John E. Emmel, MD, PC

  dba Geriatric Facility Care Specialists

  • Geriatric Medicine (Family Medicine) Physician
  • Charleston, SC
  • NPI 1235263534
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1639115066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 GAMECOCK AVE",
            "address_2": "STE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073398",
            "telephone_number": "843-769-8215",
            "fax_number": "843-769-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GAMECOCK AVE",
            "address_2": "STE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073398",
            "telephone_number": "843-769-8215",
            "fax_number": "843-769-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETREAULT",
        "first_name": "DOLORES",
        "middle_name": "YVONNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "171005",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "33970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Terry, M.D.
• John Terry, M.A.
• Kathleen Graves Terry, PA
• Trad Chanson Terry, PHARMD
• Stuart L Tessler, DPM
• Ashley Elizabeth Tetrick, OTR/L
• Anthony Wines Teves, RN, BSN
• TGD-James Island LLC
• TGD-West Ashley LLC
• Stephen Andrew Thacker, MD

• Geriatric Medicine (Internal Medicine) Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Geriatric Medicine (Internal Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.