NPIMap

Individual provider Active NPI

William Justin McCrary, M.D.

  • Dermatology Physician
  • Greenville, SC
National Provider Identifier
1780818930
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35347 Issued in SC
Practice address
28 Medical Ridge Dr
Greenville, SC 29605-4267
Phone
(864) 271-7440
NPI assigned
May 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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
Dermatology Physician 207N00000X 35347 SC Primary

Addresses

Primary practice location

28 Medical Ridge Dr
Greenville, SC 29605-4267

Mailing address

28 Medical Ridge Dr
Greenville, SC 29605-4267
Phone (864) 271-7440

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
I20130501000328 SC Practitioner - Dermatology 2365689833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Arkansas College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology of South Carolina LLCGroup PAC ID 8527049865, 18 clinicians

Practice addresses (Care Compare)

28 Medical Ridge Dr
Greenville, SC 29605-4267
Phone (864) 271-7440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.27 of 100Reported as group
Quality
90.92
Promoting interoperability
100
Improvement activities
40
Cost
76.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision216
Removal of skin lesions3016
Removal or shaving of skin growth132
Skin biopsy714

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of South Carolina LLC Dermatology CurrentSince Jul 1, 2013 Accepting new patients

Locations

317 Tanner Rd
Greenville, SC 29607
Phone (864) 627-8911

28 Medical Ridge Dr
Greenville, SC 29605
Phone (864) 271-7440

274 Commonwealth Dr
Ste A
Greenville, SC 29615
Phone (864) 686-5511

7300 Ranch Road 2222
Bldg 1
Austin, TX 78730

Interoperability endpoints

  • Direct secure messaging: william.mccrary@epiphanyderm.emadirect.md

Organizations & group practices 1

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": "1241308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1780818930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MEDICAL RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054267",
            "telephone_number": "864-271-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MEDICAL RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054267",
            "telephone_number": "864-271-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRARY",
        "first_name": "WILLIAM",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-03",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "35347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.