Greenville Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56908 Issued in NC

Legal business name

GREENVILLE INTERNAL MEDICINE

Practice address

2210 Hemby LN
Suite 101
Greenville, NC 27834-3773

Phone

(252) 830-1680

Fax

(252) 830-0926

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Leo E. Waivers, MD

Title

President

Phone

(252) 830-1680

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1093864662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343777",
            "telephone_number": "252-830-1680",
            "fax_number": "252-830-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HEMBY LN",
            "address_2": "SUITE 101",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343773",
            "telephone_number": "252-830-1680",
            "fax_number": "252-830-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "WAIVERS",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-830-1680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "56908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC",
            "identifier": "0169E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890169E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.