Table Rock Integrated Health and Wellness Practice, LLC.
NPI 1104145184 · Psychiatry Physician · Travelers Rest, SC
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Table Rock Integrated Health and Wellness Practice, LLC. is a Psychiatry Physician organization in Travelers Rest, SC (NPI 1104145184).
Provider details
- NPI number
- 1104145184
- Entity type
- Organization
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gergana Dimitrova, Partner(864) 908-6372
- License
- 30719 (SC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-05-31
- Last updated
- 2020-03-16
- Certified
- 2020-03-16
Frequently asked questions
- What is Table Rock Integrated Health and Wellness Practice, LLC.'s NPI number?
- Table Rock Integrated Health and Wellness Practice, LLC.'s National Provider Identifier (NPI) is 1104145184, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Table Rock Integrated Health and Wellness Practice, LLC.?
- Table Rock Integrated Health and Wellness Practice, LLC. is classified in the NPPES registry as Psychiatry Physician (Allopathic & Osteopathic Physicians).
- Where is Table Rock Integrated Health and Wellness Practice, LLC. located?
- Table Rock Integrated Health and Wellness Practice, LLC.'s practice location on file with NPPES is 5 Center St, Travelers Rest, SC 29690-1826.
- What is Table Rock Integrated Health and Wellness Practice, LLC.'s phone number?
- The practice phone number listed in the NPPES registry for Table Rock Integrated Health and Wellness Practice, LLC. is (864) 908-6372.
- Does Table Rock Integrated Health and Wellness Practice, LLC. accept Medicare?
- Table Rock Integrated Health and Wellness Practice, LLC. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Table Rock Integrated Health and Wellness Practice, LLC.?
- The authorized official listed on Table Rock Integrated Health and Wellness Practice, LLC.'s NPPES record is Gergana Dimitrova, Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Table Rock Integrated Health and Wellness Practice, LLC.'s NPI active?
- Yes — Table Rock Integrated Health and Wellness Practice, LLC.'s NPI (1104145184) is active in the NPPES registry as of the last update on 2020-03-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.