NPIMap

Organization Active NPI

St. Francis Physician Services, Inc

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Greenville, SC
National Provider Identifier
1396221248
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
ST. FRANCIS PHYSICIAN SERVICES, INC
Practice address
2 Innovation Dr Ste 180
Greenville, SC 29607-5265
Phone
(864) 605-3104
NPI assigned
Jul 13, 2018
Organization subpart
Yes
Parent organization
ST. FRANCIS PHYSICIAN SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Authorized official

Name
Wilbur Gay
Title
Cfo
Phone
(864) 255-1904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VF0040X Primary

Addresses

Primary practice location

2 Innovation Dr Ste 180
Greenville, SC 29607-5265

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 605-3721

Other names 1

  • Bon Secours Urogynecology 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
The OBGYN Group of Greenville39 organizations share this tax ID, including this one
Part of
The OBGYN Group of Greenville

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1396221248",
    "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": "864-605-3721",
            "fax_number": "864-605-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INNOVATION DR STE 180",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075265",
            "telephone_number": "864-605-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. FRANCIS PHYSICIAN SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. FRANCIS PHYSICIAN SERVICES, INC",
        "enumeration_date": "2018-07-13",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-255-1904"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Urogynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.