Meredith Gray Provost, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1827 Issued in SC

Practice address

129 N Washington St
Sumter, SC 29150-4949

Phone

(803) 774-9000

NPI assigned

Sep 26, 2012

Last updated

Sep 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Physician Assistant

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment
• Tuomey

  dba Professional Services of Tuomey

  • Emergency Medicine Physician
  • Sumter, SC
  • NPI 1033522941
  NPD (past)

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1699026930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N WASHINGTON ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504949",
            "telephone_number": "843-270-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N WASHINGTON ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504949",
            "telephone_number": "803-774-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "MEREDITH",
        "middle_name": "GRAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prisma Health-Midlands (Prisma Health Tuomey Hospice)
• Progressive Physical Therapy, PA (Progressive Physical Therapy Sumter)
• Erryn C Provencher, PA-C
• Providence Orthopedic Group, LLC (Moore Center for Orthopedics)
• Providers Home Care
• Adam Gregory Przybyla, M.D.
• Anna Crew Kinney Psomas, CNM, WHNP-BC
• PSW Homecare LLC (Visiting Angels - Columbia / Sumter)
• Evan Queen, PTA
• Bronwyn T. Rabon

• Medical Physician Assistant in Sumter, SC
• Providers in Sumter, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.