NPIMap

Organization Active NPI

Greenwood Surgical Assoc.

  • Surgery Physician
  • Greenwood, SC
National Provider Identifier
1154437515
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GREENWOOD SURGICAL ASSOC.
Practice address
160 Academy Ave
Greenwood, SC 29646-3808
Phone
(864) 223-8090
Fax
(864) 223-4026
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Hope A Pruitt
Title
Practice Administrator
Phone
(864) 223-8090

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

160 Academy Ave
Greenwood, SC 29646-3808

Mailing address

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

Other identifiers 1

IdentifierTypeStateIssuer
PA7037MedicaidSC

National Provider Directory

National Provider Directory

Locations

23013 Highway 76 E
Ste 100
Clinton, SC 29325
Phone (800) 233-5733

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1154437515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463808",
            "telephone_number": "864-223-8090",
            "fax_number": "864-223-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463808",
            "telephone_number": "864-223-8090",
            "fax_number": "864-223-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD SURGICAL ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "HOPE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-223-8090"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA7037",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.