Vitaliy V. Pipenko Jr.
Nurse Practitioner (Gerontology)

Address: 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609-4050
Phone: 8645225000

Vitaliy V. Pipenko Jr. (NPI# 1285012716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1285012716
Entity Type Individual
Full Name Vitaliy V. Pipenko Jr.
Credential APRN
Gender Male
Practice Address 1809 Wade Hampton Blvd Ste 120
Greenville
SC 29609-4050
Practice Telephone 8645225000
Practice Fax Number 8642324716
Mailing Address 1 Independence Pt
Ste 212
Greenville
SC 29615-4545
Mailing Telephone 8647976306
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2015-05-17
Last Update Date 2015-09-15

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LG0600X Nurse Practitioner · Gerontology Physician Assistants & Advanced Practice Nursing Providers 19427 SC

Other Provider Identifier

State Identifier Issuer Type Code
SC NP3351 MEDICAID

Physician Overview

NPI 1285012716
PAC ID by PECOS 1658686282
Professional Enrollment ID I20150811006077
Full Name Vitaliy V Pipenko
Organization Legal Name GHS PARTNERS IN HEALTH INC
Phone Number 8645225000
Gender M
Graduation Year 2015
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 8325950983
Number of Group Practice Members 1155
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
420078 GHS GREENVILLE MEMORIAL HOSPITAL
420102 GHS PATEWOOD MEMORIAL HOSPITAL
420033 GHS GREER MEMORIAL HOSPITAL

Office Location

Street Address 1809 WADE HAMPTON BLVD STE 120
City GREENVILLE
State SC
Zip Code 29609-4050

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104801828 Mary Barnett Haselden Nurse Practitioner 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609 2005-12-15
1437647633 Sharon Ross Nurse Practitioner 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609-4050 2018-04-24
1316319213 Robyn Surette Liao Nurse Practitioner 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609 2015-10-30
1487065900 Jeffery Brannan Jones Jr. Pediatrics 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609 2014-05-19
1295024404 Rose E Coady Internal Medicine 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609-4050 2011-03-29
1366487605 Kristine M Leo Nurse Practitioner 1809 Wade Hampton Blvd Ste 120, Greenville, SC 29609-4050 2006-06-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326522376 Piney Mountain Rx LLC Pharmacy 2498 North Pleasantburg Drive, Suite A, Greenville, SC 29609 2018-09-17
1417434655 Kathryn Dorothy Muschick Pediatrics 900 W. Faris Dr., Greenville, SC 29609 2018-07-20
1942705645 The Wright Home Care, LLC In Home Supportive Care 217 E Stone Ave Ste 8, Greenville, SC 29609 2018-03-26
1962917336 William W Brown, Jr. Dds Pa Dentist 1809 Wade Hampton Blvd., Suite 130, Greenville, SC 29609 2017-12-07
1780197061 Eric Reagan Bunch Physician Assistant 2498 N Pleasantburg Dr Ste B, Greenville, SC 29609 2017-11-09
1205388386 Galina Hufstetler Physical Therapist 414 Summit Drive, Apt. 313, Greenville, SC 29609 2016-10-25
1811303225 Cal Jones LLC Pharmacy 961 Montebello Dr, Suite 2, Greenville, SC 29609 2014-07-07
1982954319 John C Shaughnessy Pharmacist 1141 State Park Road, Greenville, SC 29609 2012-09-13
1770842726 Neil S Sondov Counselor 1100 Rutherford Road, Greenville, SC 29609 2012-05-11
1790044915 Crystal Ervin Counselor 1 Chick Springs Rd Ste 210a, Greenville, SC 29609 2012-05-08
Find all providers in zip 29609

Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487124616 Lucinda Smith Nurse Practitioner 10 Memorial Medical Dr, Greenville, SC 29605-4450 2018-11-30
1295219699 Suzanne Herta Gubitosa Nurse Practitioner 54 Bear Dr, Greenville, SC 29605-4458 2018-09-20
1366952376 Kathryn Lynn Phillips Nurse Practitioner 2100 Stantonsburg Rd, Greenville, NC 27834-2818 2017-10-04
1831618826 Tonya Baker Perkins Nurse Practitioner 50 Cross Park Ct, Greenville, SC 29605-4263 2017-09-12
1447782859 Amanda Elizabeth Smith Hamilton Nurse Practitioner 255 Enterprise Blvd Ste 101, Greenville, SC 29615-3530 2017-04-03
1114468303 Laticia Bryant Nurse Practitioner 2100 Stantonsburg Rd, Suite 1ad 200, Greenville, NC 27834-2818 2017-03-20
1730626813 Lauren Lee Hays Nurse Practitioner 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 2017-01-26
1932551322 Natalie R. Purdy Nurse Practitioner 529 Mills Avenue, Dba Ltc Health Solutions, Greenville, SC 29605-4218 2016-07-08
1275948309 Stephen Charles Franks Nurse Practitioner 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 2014-06-27
1235543281 Thomas Dale Godfrey Nurse Practitioner 877 W Faris Rd, Suite B, Greenville, SC 29605-4289 2014-06-18
Find all providers in GREENVILLE

Competitor

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City GREENVILLE
Zip Code 29609

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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