NPIMap

Organization Active NPI

St Francis Physician Services Inc

Doing business as Holly Tree Family Practice

  • Family Medicine Physician
  • Simpsonville, SC
National Provider Identifier
1306828587
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST FRANCIS PHYSICIAN SERVICES INC
Doing business as
Holly Tree Family Practice
Practice address
1338 Highway 14
Simpsonville, SC 29681-5637
Phone
(864) 297-7091
Fax
(877) 379-3079
NPI assigned
Nov 15, 2005
Last updated
Aug 22, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ST FRANCIS PHYSICIAN SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Wilbur R Gay III
Title
Cfo
Phone
(864) 605-3762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X SC Primary

Addresses

Primary practice location

1338 Highway 14
Simpsonville, SC 29681-5637

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 297-7091

Other names 1

  • HOLLY TREE FAMILY PRACTICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050126000259 SC Part B Supplier - Clinic/Group Practice 6608826821 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, SC; Simpsonville, SC; Greer, SC; Mauldin, SC; Taylors, SC; Travelers Rest, SC; Easley, SC; Clemson, SC…

National Provider Directory

National Provider Directory
Tax ID family
St Francis Physician Services Inc39 organizations share this tax ID, including this one
Part of
St Francis Physician Services Inc

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1306828587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-297-7091",
            "fax_number": "877-379-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 HIGHWAY 14",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815637",
            "telephone_number": "864-297-7091",
            "fax_number": "877-379-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FRANCIS PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST FRANCIS PHYSICIAN SERVICES INC",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-605-3762",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOLLY TREE FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.