Individual provider Active NPI

Charles Stuart Simko, M.D.

  • Pediatrics Physician
  • Greer, SC
National Provider Identifier
1700083375
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30172 Issued in SC
Practice address
106 Physicians Dr
Greer, SC 29650-2445
Phone
(864) 797-9100
Fax
(864) 241-9239
NPI assigned
Jun 28, 2007
Last updated
May 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30172 SC Primary

Addresses

Primary practice location

106 Physicians Dr
Greer, SC 29650-2445

Mailing address

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

Other practice location 1

890 S Pleasantburg Dr
Greenville, SC 29607-2455
Phone (864) 271-1450

Other identifiers 1

IdentifierTypeStateIssuer
301729MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csimko7257@direct.ghs.myhfn.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
I20101026000342 SC Practitioner - Pediatric Medicine 1759574460 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30172SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 2, 2010 Accepting new patients
Greenville Health System CurrentSince Aug 2, 2010 Accepting new patients
Prisma Health University Medical Group Pediatrics CurrentSince May 16, 2021 Accepting new patients
Greenville Health System Current Accepting new patients

Locations

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

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

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

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

890 S Pleasantburg Dr
Greenville, SC 29607
Phone (864) 271-1450

106 Physicians Dr
Greer, SC 29650
Phone (864) 797-9100

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: csimko7257@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1700083375",
    "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": "106 PHYSICIANS DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502445",
            "telephone_number": "864-797-9100",
            "fax_number": "864-241-9239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 S Pleasantburg Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296072455",
            "country_code": "US",
            "telephone_number": "864-271-1450",
            "fax_number": "864-271-3914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMKO",
        "first_name": "CHARLES",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "30172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301729",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csimko7257@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "csimko7257@direct.ghs.myhfn.org",
            "address_1": "106 Physicians Dr",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296502445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.