NPIMap

Individual provider Active NPI

Gowtham Gannamani, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Simpsonville, SC
National Provider Identifier
1700383569
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
86254 Issued in SC
Practice address
727 SE Main St Ste 340
Simpsonville, SC 29681-3249
Phone
(864) 455-2888
Fax
(864) 455-2885
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 86254 SC Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X LL86254 SC

Addresses

Primary practice location

727 SE Main St Ste 340
Simpsonville, SC 29681-3249

Mailing address

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

Other practice location 1

169 Ashley Ave Rm 202
Charleston, SC 29425-8905
Phone (843) 792-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230619000808 SC Practitioner - Endocrinology 5991055204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

727 S E Main St
Suite 340
Simpsonville, SC 29681-9769
Phone (864) 455-2888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86254SCMDEndocrinology, Diabetes & Metabolism Physician
LL86254SCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 10, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 10, 2023 Accepting new patients

Locations

106 Medical Park Ct
Clinton, SC 29325
Phone (803) 833-9172

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

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

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

727 SE Main St
Ste 340
Simpsonville, SC 29681
Phone (864) 455-2888

741 SE Main St
Simpsonville, SC 29681
Phone (864) 228-8453

Interoperability endpoints

  • Direct secure messaging: ggannamani707075@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 53

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1700383569",
    "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": "727 SE MAIN ST STE 340",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813249",
            "telephone_number": "864-455-2888",
            "fax_number": "864-455-2885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave Rm 202",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNAMANI",
        "first_name": "GOWTHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "86254",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "LL86254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.