NPIMap

Organization Active NPI

Jervey Eye Group, PA

  • Ophthalmology Physician
  • Easley, SC
National Provider Identifier
1700856077
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JERVEY EYE GROUP, PA
Practice address
220 S Pendleton St
Easley, SC 29640-3048
Phone
(864) 859-3233
Fax
(864) 850-4001
NPI assigned
Jan 26, 2006
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Brian W Shelley, MDNPI 1346274453
Title
Authorized Official
Phone
(864) 458-7956

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1362 SC
Optometrist 152W00000X 910 SC
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

220 S Pendleton St
Easley, SC 29640-3048

Mailing address

601 Halton Rd
Greenville, SC 29607-3403
Phone (864) 458-7956

Other identifiers 4

IdentifierTypeStateIssuer
CN1549OtherSCMEDICARE RAILROAD
DA9934MedicaidSC
DM0384OtherSCMEDICAID DMERC
GP0898MedicaidSC

National Provider Directory

National Provider Directory

Locations

140 E Main St
Easley, SC 29640
Phone (803) 859-3233

1 Doctors Dr
Greenville, SC 29605
Phone (864) 271-3354

674 Fairview Rd
Simpsonville, SC 29680
Phone (864) 963-2171

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1700856077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073403",
            "telephone_number": "864-458-7956",
            "fax_number": "864-458-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S PENDLETON ST",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296403048",
            "telephone_number": "864-859-3233",
            "fax_number": "864-850-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERVEY EYE GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "864-458-7956",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1362",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "910",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN1549",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9934",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DMERC",
            "identifier": "DM0384",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0898",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.