NPIMap

Individual provider Active NPI

Melanie Jackson, M.D.

  • Internal Medicine Physician
  • Greer, SC
National Provider Identifier
1750769659
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52048 Issued in SC
Practice address
325 Medical Pkwy Ste 200
Greer, SC 29650-2457
Phone
(864) 797-9550
Fax
(864) 797-9555
NPI assigned
May 11, 2015
Last updated
Mar 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 52048 SC Primary

Addresses

Primary practice location

325 Medical Pkwy Ste 200
Greer, SC 29650-2457

Mailing address

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

Other names 1

  • Melanie Grandstaff Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgrandstaff142135@direct-srhs.et0939.epichosted.com Direct

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
I20181012000312 SC Practitioner - Internal Medicine 9436401890 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

325 Medical Pkwy
Suite 200
Greer, SC 29650-2457
Phone (864) 797-9550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52048SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 14, 2022 Accepting new patients
Pelham Medical Center Internal Medicine CurrentSince Sep 3, 2018 Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Feb 14, 2022 Accepting new patients
Pelham Medical Center Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Internal Medicine CurrentSince Sep 3, 2018 Accepting new patients
Spartanburg Medical Center CurrentSince Sep 3, 2018 Accepting new patients
Pelham Medical Center CurrentSince Sep 3, 2018 Accepting new patients

Locations

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

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

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

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

325 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 241-7272

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 401
Spartanburg, SC 29303
Phone (864) 560-6654

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Interoperability endpoints

  • Direct secure messaging: mgrandstaff142135@direct-srhs.et0939.epichosted.com
  • Direct secure messaging: mjackson571974@direct.ghs.myhfn.org

Organizations & group practices 8

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.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1750769659",
    "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": "325 MEDICAL PKWY STE 200",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502457",
            "telephone_number": "864-797-9550",
            "fax_number": "864-797-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELANIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "52048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrandstaff142135@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mgrandstaff142135@direct-srhs.et0939.epichosted.com",
            "address_1": "101 E Wood St Ste 401",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "GRANDSTAFF",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.