Organization Active NPI

Greenville Urology, PA

  • Urology Physician
  • Greenville, SC
National Provider Identifier
1508892266
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GREENVILLE UROLOGY, PA
Practice address
52 Bear Dr
Greenville, SC 29605-4458
Phone
(864) 295-2131
Fax
(864) 605-8556
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Pat Clinton
Title
Administrator
Phone
(864) 605-8541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X SC Primary

Addresses

Primary practice location

52 Bear Dr
Greenville, SC 29605-4458

Mailing address

52 Bear Dr
Greenville, SC 29605-4458
Phone (864) 295-2131

Other identifiers 1

IdentifierTypeStateIssuer
GP2427MedicaidSC

National Provider Directory

National Provider Directory

Locations

552 Memorial Drive Ext
Ste D
Greer, SC 29651
Phone (864) 295-2131

325 Medical Pkwy
Ste 200B
Greer, SC 29650
Phone (864) 295-2131

1340 Highway 14
Simpsonville, SC 29681
Phone (864) 295-2131

Practitioners & affiliated clinicians

Practitioners 4

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": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508892266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-295-2131",
            "fax_number": "864-605-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-295-2131",
            "fax_number": "864-605-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE UROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLINTON",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "864-605-8541",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2427",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.