Healthcare Provider Details

I. General information

NPI: 1447773643
Provider Name (Legal Business Name): MORGAN GREGG SIMMONS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN JULIA GREGG PA

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PATEWOOD DR STE B200
GREENVILLE SC
29615-6321
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-454-2226
  • Fax: 864-454-2223
Mailing address:
  • Phone: 864-522-8617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2777
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2777
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2777
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: