Individual provider Active NPI

Sue Joan Jue, M.D.

  • Pediatric Infectious Diseases Physician
  • Greenville, SC
National Provider Identifier
1649223025
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
25872 Issued in SC
Practice address
200 Patewood Dr
Ste A200
Greenville, SC 29615-3593
Phone
(864) 454-5130
Fax
(864) 241-9202
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25872 SC
Pediatric Infectious Diseases Physician 2080P0208X 25872 SC Primary

Addresses

Primary practice location

200 Patewood Dr
Ste A200
Greenville, SC 29615-3593

Mailing address

1 Independence PT
Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
APPROVEDMedicaidSC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031209000057 SC Practitioner - Pediatric MedicinePractitioner - Infectious Disease 6901702281 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25872SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Pediatrics Current Accepting new patients
Shriners Hospitals for Children Pediatrics CurrentSince Dec 7, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 7, 2022 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Greenville Health System Past Accepting new patients

Locations

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

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7951

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

200 Patewood Dr
Ste A200
Greenville, SC 29615
Phone (864) 454-5115

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

Interoperability endpoints

  • Direct secure messaging: sjue7161@direct.ghs.myhfn.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1649223025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "STE A200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-454-5130",
            "fax_number": "864-241-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUE",
        "first_name": "SUE",
        "middle_name": "JOAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "25872",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "SC",
            "license": "25872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.