NPIMap

Individual provider Active NPI

Jonathan Lee Gleason, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Greenville, SC
National Provider Identifier
1780749820
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
88740 Issued in SC
Practice address
101 Halton Village Cir
Greenville, SC 29607-6825
Phone
(864) 455-1600
Fax
(864) 286-5298
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MT186681 PA
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 0101251665 VA
Gynecology Physician 207VG0400X 29368 AL
Gynecology Physician 207VG0400X 0101251665 VA
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 88740 SC Primary

Addresses

Primary practice location

101 Halton Village Cir
Greenville, SC 29607-6825

Mailing address

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

Other practice location 1

101 Elm Ave SE
Roanoke, VA 24013-2222
Phone (540) 985-4099

Other identifiers 8

IdentifierTypeStateIssuer
51599090OtherALBLUE CROSS
02536526MedicaidMS
113533MedicaidAL
557400MedicaidSC
51599089OtherALBLUE CROSS
113528MedicaidAL
113530MedicaidAL
51599092OtherALBLUE CROSS

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
I20230522000108 SC Practitioner - Obstetrics/Gynecology 2062567118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

101 Halton Rd
Greenville, SC 29607-3507
Phone (864) 455-1600

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT186681PAMDObstetrics & Gynecology Physician
88740SCMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Gynecology CurrentSince Apr 6, 2023 Accepting new patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Apr 6, 2023 Accepting new patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince May 14, 2023 Accepting new patients
University Medical Group Department of OBGYN PastSince May 14, 2023 Accepting new patients

Locations

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

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

101 Halton Village Cir
Greenville, SC 29607
Phone (864) 455-1600

101 Halton Rd
Greenville, SC 29607
Phone (864) 455-1600

Interoperability endpoints

  • Direct secure messaging: jgleason566331@direct.ghs.myhfn.org

Organizations & group practices 4

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1780749820",
    "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": "101 HALTON VILLAGE CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076825",
            "telephone_number": "864-455-1600",
            "fax_number": "864-286-5298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Elm Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240132222",
            "country_code": "US",
            "telephone_number": "540-985-4099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT186681",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "VA",
            "license": "0101251665",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AL",
            "license": "29368",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "0101251665",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "SC",
            "license": "88740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51599090",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02536526",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113533",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "557400",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51599089",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113528",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113530",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51599092",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.