Glen G Daves, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

7079 Issued in SC

Practice address

200 Patewood Dr
Suite B200
Greenville, SC 29615-3593

Phone

(864) 232-7338

Fax

(864) 239-6645

NPI assigned

Oct 3, 2006

Last updated

May 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gastroenterology Associates, PA

  • Gastroenterology Physician
  • Greenville, SC
  • NPI 1487684031
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• Gastroenterology Associates, PA

  • Gastroenterology Physician
  • Simpsonville, SC
  • NPI 1699710608
  NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Greenville Health System

  dba GHS Cardiovascular SVCS Simp

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD (past)
• New Horizon Family Health Services Inc

  dba New Horizon Family Health Services - Berea

  • Federally Qualified Health Center (FQHC)
  • Greenville, SC
  • NPI 1629872734
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1598850125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 8676",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296048676",
            "telephone_number": "864-232-7338",
            "fax_number": "864-239-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "SUITE B200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-232-7338",
            "fax_number": "864-239-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVES",
        "first_name": "GLEN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "7079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070791",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Davenport, PT
• Jake Joyner Davenport, M.D.
• Kaitlyn Davenport
• Kimberley Davenport, MD
• Megan Renee Davenport, PHARMD
• David F. Watson Jr. DMD PA
• Hamer Everett David Jr., M D
• Hannah Leah David, PA-C
• Caroline Shasta Davidson, LPN
• Harry Rhett Davidson, MSW, LISW - AP & CP

• Gastroenterology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Gastroenterology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.