NPIMap

Individual provider Active NPI

Roger Dale Boatwright, M.D.

  • Internal Medicine Physician
  • Easley, SC
National Provider Identifier
1386628071
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22401 Issued in SC
Practice address
704 N a St
Easley, SC 29640-2142
Phone
(864) 859-4480
Fax
(864) 859-3750
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22401 SC Primary

Addresses

Primary practice location

704 N a St
Easley, SC 29640-2142

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8611

Other identifiers 1

IdentifierTypeStateIssuer
L31794MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rboatwright160369@direct.ghs.myhfn.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000305 SC Practitioner - Internal Medicine 7618968744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical Group 2,467 clinicians

Practice addresses (Care Compare)

704 N a St
Easley, SC 29640-2142
Phone (864) 859-4480

Hospital & facility affiliations

  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22401SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Internal Medicine CurrentSince Sep 4, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 4, 2019 Accepting new patients
Regency Hospital of Greenville, LLC Internal Medicine CurrentSince Sep 4, 2019 Accepting new patients
Regency Hospital of Greenville, LLC CurrentSince Sep 4, 2019 Accepting new patients
Prisma Health University Medical Group Internal Medicine Current Accepting new patients
Palmetto Health Internal Medicine Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Locations

2000 E Greenville St
Fl 2
Anderson, SC 29621
Phone (864) 255-1401

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

106 John St
Ste B
Easley, SC 29640
Phone (864) 855-5104

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

704 N A St
Easley, SC 29640
Phone (864) 855-4431

101 Richard St
Easley, SC 29640
Phone (864) 442-8000

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

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

3 Saint Francis Dr
Ste 440
Greenville, SC 29601
Phone (864) 255-1401

300 W Front St
Liberty, SC 29657
Phone (864) 843-5605

Interoperability endpoints

  • Direct secure messaging: rboatwright160369@direct.ghs.myhfn.org

Organizations & group practices 11

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.

Hospital & facility affiliations 44

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1386628071",
    "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": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N A ST",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402142",
            "telephone_number": "864-859-4480",
            "fax_number": "864-859-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATWRIGHT",
        "first_name": "ROGER",
        "middle_name": "DALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "22401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L31794",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboatwright160369@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Provider",
            "address_1": "704 N A St",
            "city": "Easley",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296402142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.