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JERVEY EYE GROUP PA NPI 1538139803


NPI Information

NPI: 1538139803
Provider Name: JERVEY EYE GROUP, PA
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 42D0953399

Address:
5 STEVENS ST # 100
GREENVILLE, SC
ZIP 29605
Phone: (864) 271-3354
Get Directions

JERVEY EYE GROUP, PA is an ophthalmology in Greenville, SC. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. JERVEY EYE GROUP, PA NPI is 1538139803. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5 STEVENS ST # 100
GREENVILLE, SC
ZIP 29605-528
Phone: (864) 271-3354
Fax: (864) 250-6443

The provider's authorized official is Destiny T Green .
The authorized official title is Credentialing Manager and has the following contact phone number (864) 458-3854.

The CLIA number assigned to this NPI record is 42D0953399 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2006 and was last updated on 11/13/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2207L00000XAnesthesiology26612SOUTH CAROLINANo
3207L00000XAnesthesiology16413SOUTH CAROLINANo
4207L00000XAnesthesiology5639SOUTH CAROLINANo
5207L00000XAnesthesiology12149SOUTH CAROLINANo
6207L00000XAnesthesiology14145SOUTH CAROLINANo
7207L00000XAnesthesiology15210SOUTH CAROLINANo
8207L00000XAnesthesiology16323SOUTH CAROLINANo
9207W00000XOphthalmology291SOUTH CAROLINANo
10207W00000XOphthalmology7319SOUTH CAROLINANo
11207W00000XOphthalmology23038SOUTH CAROLINANo
12207W00000XOphthalmology8984SOUTH CAROLINANo
13207W00000XOphthalmology20313SOUTH CAROLINANo
14207W00000XOphthalmology13871SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DA9938OTHERSOUTH CAROLINAMEDICAID DMERC
2CN1548OTHERSOUTH CAROLINAMEDICARE RAILROAD
3DM0382OTHERSOUTH CAROLINAMEDICAID DMERC NUMBER
4GP0900MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.