NPIMap

Individual provider Active NPI

Corrinna J M O'Bannon

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1508045808
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2844 Issued in SC
Practice address
1005 Grove Rd
Greenville, SC 29605-4630
Phone
(864) 455-6900
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2844 SC Primary

Addresses

Primary practice location

1005 Grove Rd
Greenville, SC 29605-4630

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

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
I20060308000539 SC Practitioner - Nurse Practitioner 3971510496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

877 W Faris Rd
Suite B
Greenville, SC 29605-4296
Phone (864) 522-6225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 15, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 15, 2020 Accepting new patients
Anderson ENT, PA PastSince Apr 2, 2001 Accepting new patients

Locations

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

877 W Faris Rd
Ste B
Greenville, SC 29605
Phone (864) 522-6225

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

1005 Grove Rd
Greenville, SC 29605
Phone (864) 235-7665

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

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

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

727 SE Main St
Ste 100
Simpsonville, SC 29681
Phone (864) 454-6520

Interoperability endpoints

  • Direct secure messaging: cobannon289065@direct.ghs.myhfn.org

Organizations & group practices 3

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1508045808",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-455-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BANNON",
        "first_name": "CORRINNA",
        "middle_name": "J M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "2844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.