Individual provider Active NPI

Suzanne Dechamplain Renfro, MD

  • Anesthesiology Physician
  • Greenville, SC
National Provider Identifier
1407052939
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
17600 Issued in SC
Practice address
67 Creekside Park CT
Greenville, SC 29615-4810
Phone
(864) 242-4602
Fax
(864) 242-0129
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 17600 SC Primary

Addresses

Primary practice location

67 Creekside Park CT
Greenville, SC 29615-4810

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6015

Other identifiers 1

IdentifierTypeStateIssuer
176008MedicaidSC

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
I20040427001184 SC Practitioner - Anesthesiology 0749277234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical University of South Carolina College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

67 Creekside Park CT
Greenville, SC 29615-4810
Phone (864) 522-3700

Hospital & facility affiliations

  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17600SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Greenville Health System CurrentSince Apr 18, 2015 Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Jan 1, 2015 Accepting new patients
Greenville Anesthesiology, PA Anesthesiology Past Accepting new patients
Capitol Anesthesiology, PC Anesthesiology Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

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

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

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

1 Doctors Dr
Greenville, SC 29605
Phone (864) 271-3354

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

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

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

313 Memorial Dr
Greer, SC 29650
Phone (864) 848-8140

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

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: srenfro17866@direct.ghs.myhfn.org

Organizations & group practices 7

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1407052939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CREEKSIDE PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154810",
            "telephone_number": "864-242-4602",
            "fax_number": "864-242-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "SUZANNE",
        "middle_name": "DECHAMPLAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "17600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176008",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.