NPIMap

Organization Active NPI

Memorial Drive Medical PC, LLC

Doing business as Greer Pediatric Center

  • Pediatrics Physician
  • Greer, SC
National Provider Identifier
1922742204
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEMORIAL DRIVE MEDICAL PC, LLC
Doing business as
Greer Pediatric Center
Practice address
111 Memorial Dr
Greer, SC 29650-1518
Phone
(864) 326-4648
NPI assigned
Apr 23, 2022
Last updated
Apr 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Authorized official

Name
Dr. Joshua Andrew Hall, DONPI 1497135503
Title
Cmo
Phone
(864) 326-4648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

111 Memorial Dr
Greer, SC 29650-1518

Mailing address

296 Delbourne LN
Greer, SC 29651-7188
Phone (864) 326-4648

Other names 1

  • Greer Pediatric Center Doing business as

National Provider Directory

National Provider Directory

Locations

111 Memorial Dr
Greer, SC 29650
Phone (864) 326-4648

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650672000000",
    "number": "1922742204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 DELBOURNE LN",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296517188",
            "telephone_number": "864-326-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEMORIAL DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501518",
            "telephone_number": "864-326-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL DRIVE MEDICAL PC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "864-326-4648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greer Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 23, 2022; 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.