Network Geriatric Services, PA
Organization Active NPI Geriatric Medicine (Family Medicine) Physician · Spartanburg, SC
NPI 1922045103 · NPPES record last updated Dec 22, 2009
Key facts
- NPI
- 1922045103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- 12758 (SC)
- Legal business name
- NETWORK GERIATRIC SERVICES, PA
- Practice address
- 103 S Pine St
Spartanburg, SC 29302-1972 - Phone
- (864) 327-1510
- Fax
- (864) 327-1662
- NPI assigned
- May 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Roy Bradford Whitney, M.D.
- Title
- Ceo
- Phone
- (864) 327-1510
Practitioners 25
-
Krystal Daniel Becks, ANP-C
-
Mark W Sohner, M.D.
-
Nicole Hanna, NP
-
Patrick C Carey, M.D.
-
Theresa Faith Economou, NURSE PRACTITIONER
-
Steven Jack Gold, MD
-
Lori A Hess, MD
-
Julie A Kahler, MD
-
William A King, MD
-
Veronica Orick, MD
-
Romin Shah, M.D.
-
Tad Alan Venn, M.D.
-
Timothy Scott Beck, M.D.
-
William C Logan Jr., M.D.
-
Michele I Patton, N.P.
-
Rebecca C Tummons, M.D.
-
Ohmar Win, M.D, M.S
National Provider Directory
Locations
103 S Pine St
Spartanburg, SC 29302
Phone (864) 327-1510
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | 12758 | SC | Yes |
Addresses
Primary practice location
103 S Pine St
Spartanburg, SC 29302-1972
Mailing address
103 S Pine St
Spartanburg, SC 29302-1972
Phone (864) 327-1510
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4420 | Medicaid | SC |
NPI Registry JSON
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1261440000000",
"number": "1922045103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 S PINE ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293021972",
"telephone_number": "864-327-1510",
"fax_number": "864-327-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S PINE ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293021972",
"telephone_number": "864-327-1510",
"fax_number": "864-327-1662"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NETWORK GERIATRIC SERVICES, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-31",
"last_updated": "2009-12-22",
"status": "A",
"authorized_official_last_name": "WHITNEY",
"authorized_official_first_name": "ROY",
"authorized_official_middle_name": "BRADFORD",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "864-327-1510",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": "SC",
"license": "12758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4420",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
- La'Niaya Dy'Quesha Nesbitt
- Marcia Nesbitt
- Markeisha Antoinette Nesbitt
- Terry B Netherton
- H Heywood Nettles
- Network Pharmacy Wo, LLC
- Neurologic Care of Spartanburg PA
- New Beginnings Counseling Services
- New Beginnings Family Healthcare
- New Birth Health, LLC
All providers in Spartanburg, SC · Geriatric Medicine (Family Medicine) Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.