Individual provider Active NPI

Benjamin A Jones, PSYD

  • Psychologist
  • Greenville, SC
National Provider Identifier
1780636209
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
876 Issued in SC
Practice address
200 Patewood Dr Ste A140
Greenville, SC 29615-3585
Phone
(864) 454-5125
Fax
(864) 241-9201
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 000876 SC
Psychologist 103T00000X 876 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste A140
Greenville, SC 29615-3585

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536

Other practice location 1

900 W Faris Rd
2nd Floor
Greenville, SC 29605-4255
Phone (864) 455-8898

Other identifiers 1

IdentifierTypeStateIssuer
PS0377MedicaidSC

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101000760 SC Practitioner - Clinical Psychologist 5799702460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000876SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group Pediatrics CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

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

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

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

900 W Faris Rd
Fl 2
Greenville, SC 29605
Phone (864) 455-8898

200 Patewood Dr
Ste A140
Greenville, SC 29615
Phone (864) 454-5125

Interoperability endpoints

  • Direct secure messaging: bjones11704@direct.ghs.myhfn.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1780636209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE A140",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153585",
            "telephone_number": "864-454-5125",
            "fax_number": "864-241-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W Faris Rd",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054255",
            "country_code": "US",
            "telephone_number": "864-455-8898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "000876",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0377",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.