Active NPI
Jeffrey Wright
- Prevention Professional
- Greenville, SC
National Provider Identifier
1841847951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 200631
- Practice address
- 4 Andromeda CT
Greenville, SC 29615-5433 - Phone
- (954) 248-0737
- NPI assigned
- Aug 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 200631 | SC | Primary |
Addresses
Primary practice location
4 Andromeda CT
Greenville, SC 29615-5433
Mailing address
4 Andromeda CT
Greenville, SC 29615-5433
Phone (954) 248-0737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006301 | Medicaid | SC |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | GREENVILLE | ||
| Other URL | GREENVILLE | Health Information Exchange (HIE) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200631 | SC | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1841847951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 ANDROMEDA CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155433",
"telephone_number": "954-248-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 ANDROMEDA CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155433",
"telephone_number": "954-248-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "JEFFREY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-22",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "SC",
"license": "200631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2006301",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "GREENVILLE",
"affiliation": "N",
"address_1": "4 Andromeda Ct",
"city": "Greenville",
"state": "SC",
"country_code": "US",
"postal_code": "296155433",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "GREENVILLE",
"affiliation": "N",
"endpointDescription": "home",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "4 Andromeda Ct",
"city": "Greenville",
"state": "SC",
"country_code": "US",
"postal_code": "296155433",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.