Individual provider Active NPI

Ralph Daren Marionneaux, M.D.

  • Family Medicine Physician
  • Greer, SC
National Provider Identifier
1215946140
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40711 Issued in SC
Practice address
415 Brockman McClimon Rd
Greer, SC 29651-6608
Phone
(864) 989-1432
Fax
(864) 989-1462
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40711 SC Primary

Addresses

Primary practice location

415 Brockman McClimon Rd
Greer, SC 29651-6608

Mailing address

415 Brockman McClimon Rd
Greer, SC 29651-6608
Phone (864) 989-1432

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619001775 SC Practitioner - Family Practice 8628027703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of South Carolina Medical PC Current Accepting new patients
Premise Health of South Carolina Medical PC CurrentSince Oct 10, 2020 Accepting new patients
University Medical Group LLC Family Medicine Past Accepting new patients
Uh Internal Medicine Partners Past Accepting new patients

Locations

10 Parkway S
Greenville, SC 29615
Phone (864) 458-6933

415 Brockman McClimon Rd
Greer, SC 29651
Phone (864) 989-1432

5500 Maryland Way
Ste 120
Brentwood, TN 37027

Interoperability endpoints

  • Direct secure messaging: ralphmarionneaux@fpe.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1215946140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BROCKMAN MCCLIMON RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296516608",
            "telephone_number": "864-989-1432",
            "fax_number": "864-989-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROCKMAN MCCLIMON RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296516608",
            "telephone_number": "864-989-1432",
            "fax_number": "864-989-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIONNEAUX",
        "first_name": "RALPH",
        "middle_name": "DAREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.