Keowee Radiology P a

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

KEOWEE RADIOLOGY P A

Practice address

298 Memorial Dr
Seneca, SC 29672-9443

Phone

(864) 885-7113

NPI assigned

Jul 20, 2005

Last updated

Aug 25, 2010By 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

Blake C Poleynard, MDNPI 1508865510

Title

President

Phone

(864) 885-7113

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 4

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.

• Blake Christopher Poleynard, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1508865510
  Medicare reassignment NPD Authorized official
• Bonnie Louise Anderson, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1013916022
  Medicare reassignment NPD
• Todd Samuel Rushe, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1720087745
  Medicare reassignment NPD
• John Brian Udall, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1851390884
  Medicare reassignment NPD

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1821097825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49009",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490001",
            "telephone_number": "864-223-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729443",
            "telephone_number": "864-885-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEOWEE RADIOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "POLEYNARD",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-885-7113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3270",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9258",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth C. Dobson DMD Inc. (Keowee Smiles)
• Keowee Dialysis Center LLC
• Keowee Family Dentistry
• Keowee Family Urology
• Keowee Primary Care & Internal Medicine PC
• Keowee Surgical Clinic P.a.
• Amanda Leigh Kerr, CPHT
• Katherine Anne Kesler, LAT, ATC
• Nagy Saleh Khalil
• Joel Kenneth Kidd, M.D.

• Diagnostic Radiology Physician in Seneca, SC
• Providers in Seneca, SC by specialty
• Diagnostic Radiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.