NPIMap

Organization Active NPI

Jervey Eye Group, PA

  • Ophthalmology Physician
  • Greenville, SC
National Provider Identifier
1992775696
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
28578 Issued in SC
Legal business name
JERVEY EYE GROUP, PA
Practice address
601 Halton Rd
Greenville, SC 29607-3403
Phone
(864) 458-3900
Fax
(864) 458-8390
NPI assigned
Jan 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Authorized official

Name
Brian W Shelley, MDNPI 1346274453
Title
President
Phone
(864) 458-7956

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 646 SC
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 17064 SC
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 24224 SC
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 11002 SC
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 14023 SC
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 28578 SC Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

601 Halton Rd
Greenville, SC 29607-3403

Mailing address

601 Halton Rd
Greenville, SC 29607-3403
Phone (864) 458-7956

Other practice location 1

1 Colony Centre Way
Simpsonville, SC 29681-3286
Phone (864) 458-3900

Other practice location 2

5 Stevens St Ste 100
Greenville, SC 29605-4528
Phone (864) 250-3900

Other practice location 3

220 S Pendleton St
Easley, SC 29640-3048
Phone (864) 458-3900

Other identifiers 4

IdentifierTypeStateIssuer
DA9934MedicaidSC
CN1548OtherSCMEDICARE RAILROAD
GP0901MedicaidSC
DM0381OtherSCMEDICAID DMERC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040311000033 SC Part B Supplier - Clinic/Group Practice 2860397148 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Easley, SC; Greenville, SC; Simpsonville, SC
O20100930046475 SC DME Supplier - Physician - Optometrist 2860397148 Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jervey Eye Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

220 S Pendleton St
Easley, SC 29640
Phone (864) 250-6484

5 Stevens St
Ste 100
Greenville, SC 29605
Phone (864) 250-6487

1 Colony Centre Way
Simpsonville, SC 29681
Phone (864) 458-3900

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1992775696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073403",
            "telephone_number": "864-458-7956",
            "fax_number": "864-458-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073403",
            "telephone_number": "864-458-3900",
            "fax_number": "864-458-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Colony Centre Way",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296813286",
            "country_code": "US",
            "telephone_number": "864-458-3900",
            "fax_number": "864-228-2681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Stevens St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054528",
            "country_code": "US",
            "telephone_number": "864-250-3900",
            "fax_number": "864-250-6443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 S Pendleton St",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296403048",
            "country_code": "US",
            "telephone_number": "864-458-3900",
            "fax_number": "864-850-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JERVEY EYE GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-458-7956",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "646",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "17064",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "24224",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "11002",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "14023",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "28578",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9934",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN1548",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0901",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DMERC NUMBER",
            "identifier": "DM0381",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 23, 2026; 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.