Organization Active NPI

Greenville Neurology Consultants, PA

  • Neurology Physician
  • Greenville, SC
National Provider Identifier
1073618732
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
17836 Issued in SC
Legal business name
GREENVILLE NEUROLOGY CONSULTANTS, PA
Practice address
4 Old Grove Rd
Greenville, SC 29605-4712
Phone
(864) 242-9662
Fax
(864) 467-0980
NPI assigned
Sep 14, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Authorized official

Name
Mrs. Genna Marie Lynn, CMOM
Title
Office Manager
Phone
(864) 242-9662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 17836 SC Primary

Addresses

Primary practice location

4 Old Grove Rd
Greenville, SC 29605-4712

Mailing address

4 Old Grove Rd
Greenville, SC 29605-4712
Phone (864) 242-9662

Other identifiers 2

IdentifierTypeStateIssuer
GP1244MedicaidSC
Q29590MedicaidSC

National Provider Directory

National Provider Directory

Locations

4 Old Grove Rd
Greenville, SC 29605
Phone (864) 242-9662

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1073618732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OLD GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054712",
            "telephone_number": "864-242-9662",
            "fax_number": "864-467-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OLD GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054712",
            "telephone_number": "864-242-9662",
            "fax_number": "864-467-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE NEUROLOGY CONSULTANTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "GENNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-242-9662",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMOM"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "17836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1244",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q29590",
            "state": "SC"
        }
    ],
    "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 Mar 23, 2010; 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.