NPIMap

Individual provider Active NPI

Jonnie Lisa Greene, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1982683926
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
679 Issued in SC
Practice address
1025 Verdae Blvd
Ste a
Greenville, SC 29607-4032
Phone
(864) 240-5009
Fax
(864) 240-5028
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 679 SC Primary

Addresses

Primary practice location

1025 Verdae Blvd
Ste a
Greenville, SC 29607-4032

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
NP0077MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091008000641 SC Practitioner - Nurse Practitioner 3375689102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1025 Verdae Blvd
Greenville, SC 29607-4032

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 4, 2014 Accepting new patients
Prisma Health University Medical Group CurrentSince Feb 4, 2014 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

1025 Verdae Blvd
Ste A
Greenville, SC 29607
Phone (864) 242-4683

111 Doctors Dr
Greenville, SC 29605
Phone (864) 242-4683

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

1025 Verdae Blvd
Ste D
Greenville, SC 29607
Phone (864) 242-4683

Interoperability endpoints

  • Direct secure messaging: jgreene32752@direct.ghs.myhfn.org

Organizations & group practices 3

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.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1982683926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 VERDAE BLVD",
            "address_2": "STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074032",
            "telephone_number": "864-240-5009",
            "fax_number": "864-240-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JONNIE",
        "middle_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0077",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.