NPIMap

Organization Active NPI

Dept of Veterans Affairs

  • VA Clinic/Center
  • Greenville, SC
National Provider Identifier
1174614531
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
4776 Issued in VT
Legal business name
DEPT OF VETERANS AFFAIRS
Practice address
3510 Augusta Rd
Greenville, SC 29605-1302
Phone
(864) 299-1600
Fax
(864) 422-2604
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Dr. Mohammad Aiyub Khan, MDNPI 1306008917
Title
Staff Physician
Phone
(864) 299-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X 4776 VT Primary

Addresses

Primary practice location

3510 Augusta Rd
Greenville, SC 29605-1302

Mailing address

3510 Augusta Rd
Greenville, SC 29605-1302
Phone (864) 299-1600

Other names 1

  • GOPC Doing business as

National Provider Directory

National Provider Directory

Locations

3510 Augusta Rd
Greenville, SC 29605
Phone (864) 299-1600

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1174614531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 AUGUSTA RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051302",
            "telephone_number": "864-299-1600",
            "fax_number": "864-422-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 AUGUSTA RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051302",
            "telephone_number": "864-299-1600",
            "fax_number": "864-422-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "AIYUB",
        "authorized_official_title_or_position": "STAFF PHYSICIAN",
        "authorized_official_telephone_number": "864-299-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "VT",
            "license": "4776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 26, 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.