Individual provider Active NPI

Adam Beckett Tyson, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1386673986
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25796 Issued in SC
Practice address
1120 Grove Rd
Suite B
Greenville, SC 29605-4656
Phone
(864) 455-8897
Fax
(864) 455-8555
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25796 SC Primary

Addresses

Primary practice location

1120 Grove Rd
Suite B
Greenville, SC 29605-4656

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
APPROVEDMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atyson5063@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071024000465 SC Practitioner - Obstetrics/Gynecology 1456387307 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25796SCMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System CurrentSince Mar 9, 2010 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Mar 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Mar 1, 2010 Accepting new patients
Prisma Health-Upstate Past Accepting new patients

Locations

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

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

1120 Grove Rd
Greenville, SC 29605
Phone (864) 455-8802

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

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

1120 Grove Rd
Ste B
Greenville, SC 29605
Phone (864) 455-6444

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

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: atyson5063@direct.ghs.myhfn.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1386673986",
    "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": "1120 GROVE RD",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054656",
            "telephone_number": "864-455-8897",
            "fax_number": "864-455-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "ADAM",
        "middle_name": "BECKETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "25796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atyson5063@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "atyson5063@direct.ghs.myhfn.org",
            "address_1": "1120 Grove Rd",
            "address_2": "Suite B",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.