NPIMap

Organization Active NPI

Internal Medicine of Eastside Greer

  • Legal Medicine
  • Greer, SC
National Provider Identifier
1922076413
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
10079 Issued in SC
Legal business name
INTERNAL MEDICINE OF EASTSIDE GREER
Practice address
554 Memorial Drive Ext
Ste B
Greer, SC 29651-1155
Phone
(864) 879-7556
Fax
(864) 879-3693
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Mr. William Travis Ellsion, M.D.
Title
M.D.
Phone
(864) 879-7556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 10079 SC Primary

Addresses

Primary practice location

554 Memorial Drive Ext
Ste B
Greer, SC 29651-1155

Mailing address

554 Memorial Drive Ext Ste B
Greer, SC 29651-1155
Phone (864) 879-7556

National Provider Directory

National Provider Directory

Locations

552 Memorial Drive Ext
Ste C
Greer, SC 29651
Phone (864) 877-0570

554 Memorial Drive Ext
Ste B
Greer, SC 29651
Phone (864) 879-7556

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1922076413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 MEMORIAL DRIVE EXT STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511155",
            "telephone_number": "864-879-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 MEMORIAL DRIVE EXT",
            "address_2": "STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511155",
            "telephone_number": "864-879-7556",
            "fax_number": "864-879-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF EASTSIDE GREER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "ELLSION",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "864-879-7556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "SC",
            "license": "10079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.