Individual provider Active NPI

Gina R Padula, M.D.

  • Child & Adolescent Psychiatry Physician
  • Rock Hill, SC
National Provider Identifier
1750496311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
TL28830 Issued in SC
Practice address
101 Sedgewood Dr
Rock Hill, SC 29732-2315
Phone
(803) 328-9300
Fax
(803) 328-9309
NPI assigned
Aug 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X TL28830 SC Primary
Child & Adolescent Psychiatry Physician 2084P0804X 193164 NY

Addresses

Primary practice location

101 Sedgewood Dr
Rock Hill, SC 29732-2315

Mailing address

101 Sedgewood Dr
Rock Hill, SC 29732-2315
Phone (803) 328-9300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151209002791 SC Order and Referring Only - PsychiatryPractitioner - Psychiatry 7618278995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
193164NYMDChild & Adolescent Psychiatry Physician
TL28830SCMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Carolinas Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750496311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SEDGEWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322315",
            "telephone_number": "803-328-9300",
            "fax_number": "803-328-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SEDGEWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322315",
            "telephone_number": "803-328-9300",
            "fax_number": "803-328-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADULA",
        "first_name": "GINA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "TL28830",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "193164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.