NPIMap

Individual provider Active NPI

Vicki R Nelson, MD, PHD

  • Sports Medicine (Family Medicine) Physician
  • Greenville, SC
National Provider Identifier
1417213489
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
39824 Issued in SC
Practice address
200 Patewood Dr Ste C100
Greenville, SC 29615-6322
Phone
(864) 454-7422
Fax
(864) 454-8268
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39824 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 39824 SC Primary
Family Medicine Physician 207Q00000X 35.126659 OH
Student in an Organized Health Care Education/Training Program 390200000X LL39824 SC

Addresses

Primary practice location

200 Patewood Dr Ste C100
Greenville, SC 29615-6322

Mailing address

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

Other practice location 1

877 W Faris Rd Ste A
Greenville, SC 29605-4296
Phone (864) 455-7800

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
I20170724003499 SC Practitioner - Family Practice 2264654839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

877 W Faris Rd
Suite a
Greenville, SC 29605-4296
Phone (864) 455-8147

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.126659OHMDFamily Medicine Physician
LL39824SCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Family Medicine Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

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

877 W Faris Rd
Greenville, SC 29605
Phone (864) 455-7800

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

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

877 W Faris Rd
Ste A
Greenville, SC 29605
Phone (864) 455-7800

200 Patewood Dr
Ste B460
Greenville, SC 29615
Phone (864) 454-2226

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

200 Patewood Dr
Ste C100
Greenville, SC 29615
Phone (864) 454-7422

Interoperability endpoints

  • Direct secure messaging: vnelson126320@direct.ghs.myhfn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1417213489",
    "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": "200 PATEWOOD DR STE C100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156322",
            "telephone_number": "864-454-7422",
            "fax_number": "864-454-8268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 W Faris Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054296",
            "country_code": "US",
            "telephone_number": "864-455-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "VICKI",
        "middle_name": "R",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "39824",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "39824",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.126659",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "LL39824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.