NPIMap

Organization Active NPI

Greenville Functional Medicine

  • Clinic/Center
  • Greenville, SC
National Provider Identifier
1033545595
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
14652 Issued in SC
Legal business name
GREENVILLE FUNCTIONAL MEDICINE
Practice address
301 Halton Rd
Suite a
Greenville, SC 29607-3496
Phone
(864) 558-0200
Fax
(864) 520-1245
NPI assigned
Sep 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vickie Robbins
Title
Team Leader
Phone
(864) 558-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 14652 SC Primary

Addresses

Primary practice location

301 Halton Rd
Suite a
Greenville, SC 29607-3496

Mailing address

301 Halton Rd
Suite a
Greenville, SC 29607-3496
Phone (864) 558-0200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1033545595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HALTON RD",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073496",
            "telephone_number": "864-558-0200",
            "fax_number": "864-520-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALTON RD",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073496",
            "telephone_number": "864-558-0200",
            "fax_number": "864-520-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "TEAM LEADER",
        "authorized_official_telephone_number": "864-558-0200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "14652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.