Provider Demographics
NPI:1417076373
Name:GAINEY, JAMES SPENCER (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:SPENCER
Last Name:GAINEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-7553
Mailing Address - Country:US
Mailing Address - Phone:864-729-6626
Mailing Address - Fax:855-617-4425
Practice Address - Street 1:3516 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7553
Practice Address - Country:US
Practice Address - Phone:864-729-6626
Practice Address - Fax:855-617-4425
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00980727OtherRAILROAD MEDICARE
SC279022Medicaid
NC5918957Medicaid
SCAA25004722Medicare PIN
SCP00980727OtherRAILROAD MEDICARE
SCSC0597A6067Medicare PIN
SCAA25003361Medicare PIN
SC57-0359174OtherTAX ID