Individual provider Active NPI

Jonathan Bradford Boyd, M.D.

  • Pediatric Critical Care Medicine Physician
  • Greenville, SC
National Provider Identifier
1649624420
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
88103 Issued in SC
Practice address
701 Grove Rd FL 6
Greenville, SC 29605-4210
Phone
(864) 455-7146
Fax
(864) 455-5380
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 59156 TN
Hospitalist Physician 208M00000X 59156 TN
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Critical Care Medicine Physician 2080P0203X 88103 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 6
Greenville, SC 29605-4210

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

3601 The Vanderbilt Clinic
Nashville, TN 37232-9760
Phone (615) 322-3000

Other practice location 2

2200 Childrens Way
8161 Dot
Nashville, TN 37232-9760
Phone (615) 936-2555

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboyd19019@direct.vumc.org Direct

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
I20220830002703 SC Practitioner - Pediatric Medicine 6305235532 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88103SCMDPediatric Critical Care Medicine Physician
59156TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Pediatrics CurrentSince Aug 7, 2022 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 7, 2022 Accepting new patients
Prisma Health-Upstate Past Accepting new patients
University Medical Group Department of OBGYN PastSince Aug 28, 2022 Accepting new patients

Locations

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

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

701 Grove Rd
Fl 6
Greenville, SC 29605
Phone (864) 455-7146

Interoperability endpoints

  • Direct secure messaging: jboyd19019@direct.vumc.org
  • Direct secure messaging: jboyd599669@direct.ghs.myhfn.org

Organizations & group practices 4

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1649624420",
    "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",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 6",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7146",
            "fax_number": "864-455-5380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372329760",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Childrens Way",
            "address_2": "8161 DOT",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372329760",
            "country_code": "US",
            "telephone_number": "615-936-2555",
            "fax_number": "615-936-3601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "JONATHAN",
        "middle_name": "BRADFORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "59156",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "59156",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "SC",
            "license": "88103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboyd19019@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372329760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.