NPIMap

Individual provider Active NPI

Allyson Nicole-Willis Naylor, PA

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1093078917
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
125 Halton Rd
Greenville, SC 29607-3507
Phone
(864) 232-7338
NPI assigned
Jun 18, 2012
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

125 Halton Rd
Greenville, SC 29607-3507

Mailing address

14101 Hollyhock Dr
Simpsonville, SC 29681-3281
Phone (704) 277-6203

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
I20120926000059 SC Practitioner - Physician Assistant 6305095951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates, PAGroup PAC ID 1951215433, 57 clinicians

Practice addresses (Care Compare)

125 Halton Rd
Suite 200
Greenville, SC 29607-3507
Phone (864) 232-7338

3424 Augusta Rd
Suite 200
Greenville, SC 29605-2150
Phone (864) 232-7338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1809SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 24, 2012 Accepting new patients
Gastroenterology Associates, PA CurrentSince Aug 5, 2012 Accepting new patients
Gastroenterology Associates, PA CurrentSince Aug 5, 2012 Accepting new patients

Locations

105 Chapman Hill Rd
#A
Clemson, SC 29631

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

125 Halton Rd
Ste 200
Greenville, SC 29607

200 Patewood Dr
Ste B200
Greenville, SC 29615
Phone (864) 454-2226

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

225 E Blackstock Rd
Spartanburg, SC 29301
Phone (864) 305-2200

Organizations & group practices 4

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 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1093078917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 HOLLYHOCK DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813281",
            "telephone_number": "704-277-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073507",
            "telephone_number": "864-232-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYLOR",
        "first_name": "ALLYSON",
        "middle_name": "NICOLE-WILLIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.