Anderson Family Care, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ANDERSON FAMILY CARE, PA

Practice address

3424 Clemson Blvd
Anderson, SC 29621-1357

Phone

(864) 261-4350

Fax

(864) 261-4097

NPI assigned

Mar 29, 2006

Last updated

Mar 8, 2022By 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

Mr. Wajdi Ali Dbouk, MDNPI 1023073764

Title

Owner

Phone

(864) 261-4350

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

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.

• Wajdi Ali Dbouk, MD

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1023073764
  Medicare reassignment NPD Authorized official
• Lauren Craft Dyer, A.P.R.N.

  • Psychiatric/Mental Health Nurse Practitioner
  • Anderson, SC
  • NPI 1083848360
  NPD
• Jane L Laroche, MD

  • Internal Medicine Physician
  • Bishopville, SC
  • NPI 1902820079
  NPD
• Jill Spencer, DO

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1326148529
  NPD
• Annsley Marie Troxell, PA-C

  • Physician Assistant
  • Port Royal, SC
  • NPI 1053716050
  NPD
• Linda A Willoughby, M.D.

  • Occupational Medicine Physician
  • Atlanta, GA
  • NPI 1457578536
  NPD
• Sharon Jane Barthelmes, NP-C

  • Family Nurse Practitioner
  • Piedmont, SC
  • NPI 1043449705
  NPD (past)
• Gwendell McDaniel Kelley, APRN

  • Family Nurse Practitioner
  • Anderson, SC
  • NPI 1194222539

  Family Medicine

  NPD (past)
• Carolyn Blanche Mega, FNP

  • Family Nurse Practitioner
  • Belton, SC
  • NPI 1942231873
  NPD (past)
• Winston B Morris, MD

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1295791184
  NPD (past)
• Mabra Glenn Abernathy, M.D.

  • Family Medicine Physician
  • Coralville, IA
  • NPI 1316922545
  NPD (past)
• Marlon Decastro, M.D.

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1780643270
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1942261185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211357",
            "telephone_number": "864-261-4350",
            "fax_number": "864-261-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211357",
            "telephone_number": "864-261-4350",
            "fax_number": "864-261-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON FAMILY CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "DBOUK",
        "authorized_official_first_name": "WAJDI",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-261-4350",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2619",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anderson Diagnostic Imaging, LLC (Anderson Radiology)
• Anderson Diagnostic Imaging, LLC (Anderson Radiology)
• Anderson ENT, PA
• Anderson Eye & Ear Associates, P.a. (Medicus)
• Anderson Eye Associates, PA
• Anderson Family Dental Care PA
• Anderson Foot Clinic
• Anderson Free Clinic (Anderson Free Clinic Pharmacy)
• Anderson Free Clinic, Inc (Anderson Free Clinic)
• Anderson General Dentistry Associates, P.C.

• Family Medicine Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.