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NPI Code Detail

MEDICARE: JERVEY EYE GROUP, PA

MEDICARE: JERVEY EYE GROUP, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician
2207W00000XOphthalmology Physician24224SC
3207W00000XOphthalmology Physician17064SC
4152W00000XOptometrist646SC
5207W00000XOphthalmology Physician14023SC
6207W00000XOphthalmology Physician11002SC
7207W00000XOphthalmology Physician28578SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CN1548OTHERSCMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992775696
Entity Type Code : Organization
Provider Name (Legal Business Name) : JERVEY EYE GROUP, PA
Provider Business Mailing Address
First Line : 601 HALTON RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-3403
Country : US
Telephone Number : 864-458-7956
Fax Number : 864-458-8390
Provider Business Practice Location Address
First Line : 601 HALTON RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-3403
Country : US
Telephone Number : 864-458-3900
Fax Number : 864-458-8390
Authorized Official
Title or Position : PRESIDENT
Name : BRIAN W SHELLEY
Credential : MD
Telephone Number : 864-458-7956
Provider Enumeration Date : 01/25/2006
Last Update Date : 06/23/2026

Similar Medicare Providers

1386614238 — JAMES W CULCLASURE JR. M.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390
1881664878 — DR. WILLIAM H BALLINGER JR. M.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390
1629048624 — DR. MARK H COOK M.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390
1538139415 — DR. EDWARD LAMAR LEHMAN M.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390
1235109802 — DR. HAROLD E SHAW JR. M.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390
1669442240 — DR. ALBERT JAMES LYDAY JR. O.D.
Practice Location Address:
601 HALTON RD
GREENVILLE, SC
29607-3403
Practice Phone: 864-458-7956
Practice Fax: 864-458-8390

Directions to “JERVEY EYE GROUP, PA ” Practice Location

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