Elizabeth Streett Tyson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30313 Issued in SC

Practice address

20 Medical Ridge Dr
Greenville, SC 29605-4267

Phone

(864) 220-7270

Fax

(864) 241-9211

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Pediatric Medicine

Education

Medical University of South Carolina College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: etyson11698@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Greenville Health System

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD (past)
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  NPD (past)
• Department of Pediatrics University of Utah

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1679528715
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1295814762",
    "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": "20 MEDICAL RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054267",
            "telephone_number": "864-220-7270",
            "fax_number": "864-241-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "ELIZABETH",
        "middle_name": "STREETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "30313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303139",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "576007863102",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "etyson11698@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "etyson11698@direct.ghs.myhfn.org",
            "address_1": "20 Medical Ridge Dr",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Royal Tyler, PA-C
• Kacie Nicole Tyner, FNP-C
• Tyson Medical Supplies Inc
• Adam Beckett Tyson, M.D.
• Cathleen Tyson, OTR/L
• Megan Dennis Tyson
• Melinda K Tyson, MS
• U-DO-Matter Health and Wellness LLC
• Haley Danielle Ubillus, PNP
• John Brian Udall, MD

• Pediatrics Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.

Verify at the official NPI Registry.