Gwendolyn Elaine Peterson-Taitague

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24676 Issued in SC

Practice address

1535 Platt Springs Rd # 4283
West Columbia, SC 29169-5502

Phone

(760) 223-3098

NPI assigned

Jun 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gwendolyn Elaine Taitague Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Bella Vista Continued Care Home

  • Assisted Living Facility
  • Columbia, SC
  • NPI 1356983027
  NPD

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1679149280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 PLATT SPRINGS RD # 4283",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 PLATT SPRINGS RD # 4283",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695502",
            "telephone_number": "760-223-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON-TAITAGUE",
        "first_name": "GWENDOLYN",
        "middle_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "TAITAGUE",
            "middle_name": "ELAINE",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Allyson Crossley Perry, PA-C
• Christopher Taylor Perry, D.O.
• Personal Care Plus (Robin Basnight DBA Personal Care Plus)
• Ariel Alejandro Pertile, MD
• Stephan Peters, DC
• Black Peterson, CNIM
• Eric Peterson, D.O.
• Brentney Petree, LMFT
• Pets Inc Pharmacy (The Farmacy at PETSinc)
• Hannah Elizabeth Pettigrew

• Family Nurse Practitioner in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.