NPIMap

Individual provider Active NPI

Vanessa A Mazzoli, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1437250768
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
15568 Issued in SC
Practice address
213 Halton Rd
Greenville, SC 29607-3509
Phone
(864) 382-4000
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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 15568 SC Primary

Addresses

Primary practice location

213 Halton Rd
Greenville, SC 29607-3509

Mailing address

213 Halton Rd
Greenville, SC 29607-3509
Phone (864) 382-4000

Other identifiers 1

IdentifierTypeStateIssuer
PC1173MedicaidSC

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
I20050505000600 SC Practitioner - Obstetrics/Gynecology 2769422021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

213 Halton Rd
Greenville, SC 29607-3509
Phone (864) 382-4000

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15568SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Obstetrics & Gynecology CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc CurrentSince Jan 1, 2005 Accepting new patients
St Francis Physician Services Inc Obstetrics & Gynecology Past Accepting new patients

Locations

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

213 Halton Rd
Greenville, SC 29607
Phone (864) 382-4000

Interoperability endpoints

  • Direct secure messaging: vmazzoli1153536@direct.bsmhealth.org

Organizations & group practices 4

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1437250768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073509",
            "telephone_number": "864-382-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073509",
            "telephone_number": "864-382-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLI",
        "first_name": "VANESSA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "15568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1173",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.