Individual provider Active NPI

Charles D Ross, M.D.

  • Cardiovascular Disease Physician
  • Greenville, SC
National Provider Identifier
1396737854
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
7611 Issued in SC
Practice address
2 Innovation Dr
Suite 400
Greenville, SC 29607-5261
Phone
(864) 235-7665
Fax
(864) 233-5971
NPI assigned
Aug 19, 2005
Last updated
Feb 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 7611 SC Primary

Addresses

Primary practice location

2 Innovation Dr
Suite 400
Greenville, SC 29607-5261

Mailing address

2 Innovation Dr
Suite 400
Greenville, SC 29607-5261
Phone (864) 235-7665

Other identifiers 1

IdentifierTypeStateIssuer
GP0975MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007611SCMDPharmacist
7611SCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc Past Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1396737854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 INNOVATION DR",
            "address_2": "SUITE 400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075261",
            "telephone_number": "864-235-7665",
            "fax_number": "864-233-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INNOVATION DR",
            "address_2": "SUITE 400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075261",
            "telephone_number": "864-235-7665",
            "fax_number": "864-233-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "7611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0975",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.