NPIMap

Organization Active NPI

Pelham Family Practice LLC

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1891773115
Registry record updated Jan 30, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PELHAM FAMILY PRACTICE LLC
Practice address
25 Creekview CT
Greenville, SC 29615-4800
Phone
(864) 297-7900
Fax
(864) 458-8841
NPI assigned
Jan 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Lyn H Hammond, MD
Title
President
Phone
(864) 297-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

25 Creekview CT
Greenville, SC 29615-4800

Mailing address

25 Creekview CT
Greenville, SC 29615-4800
Phone (864) 297-7900

Other identifiers 1

IdentifierTypeStateIssuer
GP2355MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1891773115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CREEKVIEW CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-297-7900",
            "fax_number": "864-458-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CREEKVIEW CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-297-7900",
            "fax_number": "864-458-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "LYN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-297-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2355",
            "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 Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.