Medexpress Primary Care South Carolina, P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MEDEXPRESS PRIMARY CARE SOUTH CAROLINA, P.C.

Doing business as

Greenville Michelin Family Health Center

Practice address

525 Michelin Rd
Greenville, SC 29605

Phone

(864) 458-1376

Fax

(864) 458-1382

NPI assigned

Jun 20, 2018

Last updated

Jul 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brett Gall

Title

Director Payor Contracting

Phone

(304) 225-2500

Specialties & licenses 2

Addresses

Other names 1

• Greenville Michelin Family Health Center Doing business as

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1285128462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MICHELIN RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-458-1376",
            "fax_number": "864-458-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS PRIMARY CARE SOUTH CAROLINA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIRECTOR PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Michelin Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Meawad
• Med-Trans Corporation
• Medaclaim (MedEclaim)
• Michael George Medcalf, DMD
• Medcenter 24/7 LLC
• Medexpress Primary Care South Carolina, P.C. (HNA Michelin Family Health Center)
• Medfirst Staffing, LLC
• Madeline Medford
• Medical Billing Center of the South, LLC
• Medical Center Orthotics and Prosthetics, LLC

• General Practice Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.