NPIMap

Individual provider Active NPI

Caleb Thomas Senn, MD

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1083241772
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T-4012 Issued in MS
Practice address
113 Doctors Dr
Greenville, SC 29605-5608
Phone
(864) 269-3333
Fax
(864) 626-0757
NPI assigned
Mar 24, 2020
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T-4012 MS Primary

Addresses

Primary practice location

113 Doctors Dr
Greenville, SC 29605-5608

Mailing address

1634 Norwich Ave
Jackson, MS 39211-6050
Phone (803) 530-2327

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726001249 SC Practitioner - Ophthalmology 3870903305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Carolina School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 Doctors Dr
Greenville, SC 29605-5608
Phone 86426933332271

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery189
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-4012MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Associates of South Carolina, PA CurrentSince Jul 24, 2024 Accepting new patients
Southern Eye Associates of SC, PA CurrentSince Jul 24, 2024 Accepting new patients
Southern Eye Associates of SC, PA Past Accepting new patients

Locations

161 Thomas Green Blvd
Clemson, SC 29631
Phone (864) 269-3333

110 Mall Connector Rd
Ste 101
Greenville, SC 29607
Phone (864) 269-3333

113 Doctors Dr
Greenville, SC 29605
Phone (864) 269-3333

100 Physicians Dr
Greer, SC 29650
Phone (864) 269-3333

100 Allawood Ct
Simpsonville, SC 29681
Phone (864) 269-3333

100 Allawood Ct
Ste 102
Simpsonville, SC 29681

Interoperability endpoints

  • Direct secure messaging: caleb.senn.p2@direct.clemsoneye.nextgenshare.com
  • Direct secure messaging: csenn@southerneye.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1083241772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 NORWICH AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116050",
            "telephone_number": "803-530-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055608",
            "telephone_number": "864-269-3333",
            "fax_number": "864-626-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENN",
        "first_name": "CALEB",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-4012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.