Jervey Eye Center, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

ASF-038 Issued in SC

Legal business name

JERVEY EYE CENTER, LLC

Practice address

5 Stevens St Ste 200
Greenville, SC 29605-4528

Phone

(864) 250-6484

Fax

(864) 250-6490

NPI assigned

Dec 12, 2007

Last updated

Sep 14, 2023By 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

Brian W Shelley, MDNPI 1346274453

Title

President/Managing Partner

Phone

(864) 458-7956

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Jervey Eye Center,LLC

  • Ambulatory Surgical Clinic/Center
  • Greenville, SC
  • NPI 1275503906

  8224924790

  Same PAC ID

Locations

Practitioners 3

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.

• David A Fleming, MD

  • Anesthesiology Physician
  • Greenville, SC
  • NPI 1821006669
  Medicare reassignment NPD
• Brian Wells Shelley, M.D.

  • Ophthalmology Physician
  • Greenville, SC
  • NPI 1346274453
  NPD Authorized official
• Karen F. Medlin, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
  • NPI 1922062603
  Medicare reassignment

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1366625485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 STEVENS ST STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054528",
            "telephone_number": "864-250-6484",
            "fax_number": "864-250-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 STEVENS ST STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054528",
            "telephone_number": "864-250-6484",
            "fax_number": "864-250-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERVEY EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/MANAGING PARTNER",
        "authorized_official_telephone_number": "864-458-7956",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "SC",
            "license": "ASF-038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CI9006",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0900",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stelina Jennings, NP
• Tyra Jennings
• Trenton F Jensen, DMD
• Kyle James Jeray, M.D.
• Fritz Morgan Jernigan, L.M.B.T
• Jervey Eye Center,LLC
• Jervey Eye Group, PA
• Jervey Eye Group, PA
• Jervey Eye Group, PA
• Jervey Eye Group, PA

• Ophthalmologic Surgery Clinic/Center in Greenville, SC
• Providers in Greenville, SC by specialty
• Ophthalmologic Surgery Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.