NPIMap

Organization Active NPI

Greenville-Pediatrics PA

  • Pediatrics Physician
  • Greenville, SC
National Provider Identifier
1720102809
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14106 Issued in SC
Legal business name
GREENVILLE-PEDIATRICS PA
Practice address
37 Brendan Way
Greenville, SC 29615-3514
Phone
(864) 458-7792
NPI assigned
Mar 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brian Harvey Washburn, M.D.NPI 1760585657
Title
President
Phone
(864) 458-7792

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 14106 SC Primary

Addresses

Primary practice location

37 Brendan Way
Greenville, SC 29615-3514

Mailing address

37 Brendan Way
Greenville, SC 29615-3514
Phone (864) 458-7792

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720102809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BRENDAN WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153514",
            "telephone_number": "864-458-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BRENDAN WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153514",
            "telephone_number": "864-458-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE-PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASHBURN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-458-7792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "14106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.