NPIMap

Organization Active NPI

Bon Secours Medical Group Greenville Specialty Care LLC

Doing business as Carolina Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Greenville, SC
National Provider Identifier
1508501313
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BON SECOURS MEDICAL GROUP GREENVILLE SPECIALTY CARE LLC
Doing business as
Carolina Orthopaedic Center
Practice address
317 Saint Francis Dr Ste 310
Greenville, SC 29601-3968
Phone
(864) 234-9900
Fax
(864) 234-9090
NPI assigned
May 5, 2022
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Wilbur Gay
Title
Cfo
Phone
(864) 605-3762

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Hand Surgery Physician 207XS0106X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X
Orthopaedic Surgery of the Spine Physician 207XS0117X
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X

Addresses

Primary practice location

317 Saint Francis Dr Ste 310
Greenville, SC 29601-3968

Mailing address

PO Box 631341
Cincinnati, OH 45263-1341

Other names 1

  • CAROLINA ORTHOPAEDIC CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220609002492 SC DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1850779976 Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours Medical Group Greenville Specialty Care LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1508501313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631341",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 SAINT FRANCIS DR STE 310",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013968",
            "telephone_number": "864-234-9900",
            "fax_number": "864-234-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MEDICAL GROUP GREENVILLE SPECIALTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-605-3762"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAROLINA ORTHOPAEDIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 5, 2022; 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.