NPIMap

Organization Active NPI

St Francis Physician Services Inc

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1962656892
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST FRANCIS PHYSICIAN SERVICES INC
Practice address
2 Innovation Dr.
Suite 140
Greenville, SC 29607-5263
Phone
(864) 295-1750
Fax
(864) 295-1753
NPI assigned
Nov 5, 2008
Organization subpart
Yes
Parent organization
ST FRANCIS PHYSICIAN SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Wilbur R Gay III
Title
Cfo
Phone
(864) 605-3762

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X SC Primary

Addresses

Primary practice location

2 Innovation Dr.
Suite 140
Greenville, SC 29607-5263

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 295-1750

Other identifiers 1

IdentifierTypeStateIssuer
GP5049MedicaidSC

Other names 1

  • Internal Medicine and Diagnostic Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050126000259 SC Part B Supplier - Clinic/Group Practice 6608826821 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, SC; Simpsonville, SC; Greer, SC; Mauldin, SC; Taylors, SC; Travelers Rest, SC; Easley, SC; Clemson, SC…

National Provider Directory

National Provider Directory
Part of
The OBGYN Group of Greenville

Locations

135 Commonwealth Dr
Ste 100
Greenville, SC 29615
Phone (864) 365-0200

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1962656892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-295-1750",
            "fax_number": "864-295-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INNOVATION DR.",
            "address_2": "SUITE 140",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075263",
            "telephone_number": "864-295-1750",
            "fax_number": "864-295-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FRANCIS PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST FRANCIS PHYSICIAN SERVICES INC",
        "enumeration_date": "2008-11-05",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-605-3762",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5049",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine and Diagnostic Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Internal Medicine and Diagnostic Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.