NPIMap

Organization Active NPI

Upstate Psychiatry, PA

  • Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1497792592
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UPSTATE PSYCHIATRY, PA
Practice address
27 Memorial Medical Dr
Greenville, SC 29605-4407
Phone
(864) 295-2221
Fax
(864) 220-6109
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Dr. Barnwell Rhett Myers III, MDNPI 1891746830
Title
President
Phone
(864) 295-2221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

27 Memorial Medical Dr
Greenville, SC 29605-4407

Mailing address

27 Memorial Medical Dr
Greenville, SC 29605-4407
Phone (864) 295-2221

Other identifiers 1

IdentifierTypeStateIssuer
GP0913MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000065 SC Part B Supplier - Clinic/Group Practice 1557266251 Receives reassigned benefits from 4 practitioners
Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Locations

27 Memorial Medical Dr
Greenville, SC 29605
Phone (864) 295-2221

Practitioners & affiliated clinicians

Practitioners 11

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": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1497792592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MEMORIAL MEDICAL DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054407",
            "telephone_number": "864-295-2221",
            "fax_number": "864-220-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MEMORIAL MEDICAL DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054407",
            "telephone_number": "864-295-2221",
            "fax_number": "864-220-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PSYCHIATRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "BARNWELL",
        "authorized_official_middle_name": "RHETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-295-2221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0913",
            "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 Oct 11, 2007; 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.