Active NPI
Jane Vance Gwinn, M.D.
- Pediatric Pulmonology Physician
- Greenville, SC
National Provider Identifier
1821089103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 11118
- Practice address
- 48 Creekview CT
Greenville, SC 29615-4800 - Phone
- (864) 458-7431
- Fax
- (864) 458-7463
- NPI assigned
- Nov 4, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 11118 | SC | Primary |
Addresses
Primary practice location
48 Creekview CT
Greenville, SC 29615-4800
Mailing address
PO Box 2145
Skyland, NC 28776-2145
Phone (828) 575-2644
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111186 | Medicaid | SC | |
| AA74976910 | Other | SC | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11118 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1821089103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2145",
"city": "SKYLAND",
"state": "NC",
"postal_code": "287762145",
"telephone_number": "828-575-2644",
"fax_number": "828-350-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 CREEKVIEW CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154800",
"telephone_number": "864-458-7431",
"fax_number": "864-458-7463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWINN",
"first_name": "JANE",
"middle_name": "VANCE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-04",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "SC",
"license": "11118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111186",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "AA74976910",
"state": "SC"
}
],
"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 Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.