Individual provider Active NPI

Sybil C. Harrelson, NPP

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1902953201
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AC77 Issued in SC
Practice address
1005 Grove Rd
Greenville, SC 29605-4630
Phone
(864) 235-7665
Fax
(864) 233-5971
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AC77 SC Primary

Addresses

Primary practice location

1005 Grove Rd
Greenville, SC 29605-4630

Mailing address

1005 Grove Rd
Greenville, SC 29605-4630
Phone (864) 235-7655

Other identifiers 1

IdentifierTypeStateIssuer
GP0975MedicaidSC

Other names 1

  • Miss Sybil M Childers Former name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC77SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc Past Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1902953201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-235-7655",
            "fax_number": "864-233-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-235-7665",
            "fax_number": "864-233-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELSON",
        "first_name": "SYBIL",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "AC77",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0975",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYBIL",
            "last_name": "CHILDERS",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 5, 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.