Active NPI
Jennifer Difelice
- Family Medicine Physician
- Greenville, SC
National Provider Identifier
1174228134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 90163
- Practice address
- 877 W Faris Rd Ste a
Greenville, SC 29605-4296 - Phone
- (864) 455-7800
- Fax
- (864) 455-9082
- NPI assigned
- Mar 31, 2023
- Last updated
- Aug 4, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 90163 | SC | Primary |
Addresses
Primary practice location
877 W Faris Rd Ste a
Greenville, SC 29605-4296
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230912003132 | SC | Order and Referring Only - Family Practice | 7810351699 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Medical College of Georgia School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
300 E McBee Ave
Greenville, SC 29601-2842
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL90163 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1174228134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 W FARIS RD STE A",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054296",
"telephone_number": "864-455-7800",
"fax_number": "864-455-9082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFELICE",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-31",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "90163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.