Oak Street Health Physicians Group Of South Carolina, Llc - Medicare Mental Health Clinic in Greenville, SC

Oak Street Health Physicians Group Of South Carolina, Llc is a medicare enrolled mental health clinic (Clinic/center - Primary Care) in Greenville, South Carolina. The current practice location for Oak Street Health Physicians Group Of South Carolina, Llc is 6119 White Horse Rd Ste 14, Greenville, South Carolina. For appointments, you can reach them via phone at (312) 733-9730. The mailing address for Oak Street Health Physicians Group Of South Carolina, Llc is 30 W Monroe St Ste 1200, Chicago, Illinois and phone number is (312) 733-9730.

Oak Street Health Physicians Group Of South Carolina, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1023614914. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (312) 733-9730.

Contact Information

Oak Street Health Physicians Group Of South Carolina, Llc
6119 White Horse Rd Ste 14
Greenville
SC 29611-3838
(312) 733-9730
Not Available

Map and Direction


Mental Health Clinic Profile

Full NameOak Street Health Physicians Group Of South Carolina, Llc
SpecialityClinic/Center
Location6119 White Horse Rd Ste 14, Greenville, South Carolina
Authorized Official Name and PositionGriffin Myers (CMO)
Authorized Official Contact3072642085
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Oak Street Health Physicians Group Of South Carolina, Llc
30 W Monroe St Ste 1200
Chicago
IL 60603-2420

Ph: (312) 733-9730
Oak Street Health Physicians Group Of South Carolina, Llc
6119 White Horse Rd Ste 14
Greenville
SC 29611-3838

Ph: (312) 733-9730

NPI Details:

NPI Number1023614914
Provider Enumeration Date12/07/2020
Last Update Date06/29/2023
Certification Date06/29/2023

Medicare PECOS Information:

Medicare PECOS PAC ID3375959075
Medicare Enrollment IDO20210303003162

Medical Identifiers

Medical identifiers for Oak Street Health Physicians Group Of South Carolina, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023614914NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Primary
363L00000XNurse Practitioner (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Oak Street Health Physicians Group Of South Carolina, Llc acts as a billing entity for following providers:
Provider NameTad Venn
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891810479
PECOS PAC ID: 0244386415
Enrollment ID: I20090914000545
Provider NameRoland Ivan Saavedra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427011089
PECOS PAC ID: 4183711880
Enrollment ID: I20100726000427
Provider NameTisha A Williams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619084308
PECOS PAC ID: 5193638955
Enrollment ID: I20110315000735
Provider NameSteven Miszkiewicz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1548257249
PECOS PAC ID: 1456343128
Enrollment ID: I20110927000516
Provider NameLatanya K Wright
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538398664
PECOS PAC ID: 7012061633
Enrollment ID: I20140407001813
Provider NameLakeisha Shunte Henderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346613213
PECOS PAC ID: 7113228180
Enrollment ID: I20151216000934
Provider NameCynthia C Morris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366806069
PECOS PAC ID: 2264722941
Enrollment ID: I20160608002076
Provider NameRobert Kirby
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1568675551
PECOS PAC ID: 1658667563
Enrollment ID: I20160901000088
Provider NameShaquan Martee Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053868810
PECOS PAC ID: 4284906140
Enrollment ID: I20170828001972
Provider NameAmanda Elizabeth Smith Hamilton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447782859
PECOS PAC ID: 6103183959
Enrollment ID: I20171202000150
Provider NameNicole Marie Segarra
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811410475
PECOS PAC ID: 6800155755
Enrollment ID: I20180122002613
Provider NameCynthia Bishop Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275046146
PECOS PAC ID: 9436419611
Enrollment ID: I20180208000307
Provider NameJamie C Goodman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1013956663
PECOS PAC ID: 4183607724
Enrollment ID: I20191107001578
Provider NameJeremy Alex Fuller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841821162
PECOS PAC ID: 4082041660
Enrollment ID: I20200220000004
Provider NameGriffin Myers
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1871817643
PECOS PAC ID: 7719145127
Enrollment ID: I20210303003257
Provider NameDillon Miller
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619199056
PECOS PAC ID: 9436247319
Enrollment ID: I20210318000089
Provider NameJustin Hunt
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1326138074
PECOS PAC ID: 6901842228
Enrollment ID: I20210318000436
Provider NameRachel Sabb
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629321096
PECOS PAC ID: 0547412371
Enrollment ID: I20210610000391
Provider NameLisa Marie Amodio
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1063415909
PECOS PAC ID: 0941271951
Enrollment ID: I20220203000811
Provider NameRachel Hildebrand
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528531258
PECOS PAC ID: 7416299748
Enrollment ID: I20220504001890
Provider NameTuwanda Williamson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629018528
PECOS PAC ID: 6608817630
Enrollment ID: I20220511000447
Provider NameMarisa Rogers
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1336171628
PECOS PAC ID: 8022185610
Enrollment ID: I20220808002492
Provider NameAdrenna R Jackson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912644246
PECOS PAC ID: 1951784164
Enrollment ID: I20220822001835
Provider NameMira Desai
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538559190
PECOS PAC ID: 6800104787
Enrollment ID: I20220907000246
Provider NameTimanika Dansby
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083016547
PECOS PAC ID: 5698061299
Enrollment ID: I20220909001049
Provider NameAiyanna Daishawn Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780302398
PECOS PAC ID: 6406228758
Enrollment ID: I20230214002125
Provider NamePhyllis Milburn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164776563
PECOS PAC ID: 1850664897
Enrollment ID: I20231221000630
Provider NameKathryn Denhof
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649934571
PECOS PAC ID: 1052757382
Enrollment ID: I20240308003337
Provider NameLevita Robinson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1255606554
PECOS PAC ID: 3375852650
Enrollment ID: I20240425002442
Provider NameFayona Curenton
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1336508878
PECOS PAC ID: 7113289588
Enrollment ID: I20240516000170
Provider NameMichelle L Rogers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457100869
PECOS PAC ID: 2961937321
Enrollment ID: I20241121002015
Provider NameAngela Renee Berry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174983878
PECOS PAC ID: 0749586022
Enrollment ID: I20241126001103

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.