Individual provider Active NPI

Ryan C Pickens

  • Pediatric Surgery Physician
  • Greenville, SC
National Provider Identifier
1255785358
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
95019 Issued in SC
Practice address
48 Cross Park CT
Greenville, SC 29605-4263
Phone
(864) 797-7400
NPI assigned
Apr 15, 2016
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 218749 NC
Pediatric Surgery Physician 2086S0120X 95019 SC Primary

Addresses

Primary practice location

48 Cross Park CT
Greenville, SC 29605-4263

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

501 Epting Ave
Greenwood, SC 29646-4091
Phone (864) 797-7400

Other identifiers 1

IdentifierTypeStateIssuer
218749OtherNCNORTH CAROLINA MEDICAL BOARD RESIDENCY TRAINING LICENSE FILE ID#

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
I20250827002787 SC Practitioner - General Surgery 0749559250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
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

LicenseStateTypeSpecialty
218749NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Oct 6, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 6, 2025 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

300 E McBee Ave
Ste 300
Greenville, SC 29601

48 Cross Park Ct
Greenville, SC 29605
Phone (864) 235-1122

501 Epting Ave
Greenwood, SC 29646
Phone (864) 227-8932

Interoperability endpoints

  • Direct secure messaging: rpickens631498@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: rpickens884686@direct.ghs.myhfn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1255785358",
    "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",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CROSS PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054263",
            "telephone_number": "864-797-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Epting Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296464091",
            "country_code": "US",
            "telephone_number": "864-797-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "RYAN",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "218749",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "SC",
            "license": "95019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD RESIDENCY TRAINING LICENSE FILE ID#",
            "identifier": "218749",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.