NPIMap

Individual provider Active NPI

Todd Robert Fennell, MD

  • Internal Medicine Physician
  • Greer, SC
National Provider Identifier
1083639884
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28189 Issued in SC
Practice address
325 Medical Pkwy Ste 200
Greer, SC 29650-2457
Phone
(864) 797-9550
Fax
(864) 797-9555
NPI assigned
Jul 13, 2006
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28189 SC Primary
Hospitalist Physician 208M00000X 28189 SC
Hospitalist Physician 208M00000X LL28189 SC

Addresses

Primary practice location

325 Medical Pkwy Ste 200
Greer, SC 29650-2457

Mailing address

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

2755 S Highway 14
Suite 1210
Greer, SC 29650-4902
Phone (864) 879-7556

Other identifiers 1

IdentifierTypeStateIssuer
281894MedicaidSC

Other names 1

  • Todd Robert Klocker Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfennell8472@direct-srhs.et0939.epichosted.com Direct

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
I20080218000413 SC Practitioner - Internal Medicine 8820171622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

325 Medical Pkwy
Suite 200
Greer, SC 29650-2457
Phone (864) 797-9550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL28189SCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 6, 2022 Accepting new patients
Spartanburg Medical Center Internal Medicine CurrentSince Dec 1, 2013 Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Jun 6, 2022 Accepting new patients
Spartanburg Medical Center CurrentSince Nov 1, 2016 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2013 Accepting new patients
Southeastern Physician Services PC Internal Medicine Past Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Greenville, SC 29601
Phone (803) 434-1335

2755 S Highway 14
#1210
Greer, SC 29650
Phone (864) 879-7556

2755 S Highway 14
Ste 1210
Greer, SC 29650
Phone (864) 879-7556

325 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 241-7272

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Interoperability endpoints

  • Direct secure messaging: tfennell123057@direct.ghs.myhfn.org

Organizations & group practices 9

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 53

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

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1083639884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MEDICAL PKWY STE 200",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502457",
            "telephone_number": "864-797-9550",
            "fax_number": "864-797-9555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2755 S Highway 14",
            "address_2": "Suite 1210",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296504902",
            "country_code": "US",
            "telephone_number": "864-879-7556",
            "fax_number": "864-879-3693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "TODD",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "28189",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "28189",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "LL28189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281894",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfennell8472@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tfennell8472@direct-srhs.et0939.epichosted.com",
            "address_1": "2755 S Highway 14",
            "address_2": "Suite 1210",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296504902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TODD",
            "last_name": "KLOCKER",
            "middle_name": "ROBERT",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.