GREENVILLE FACIAL PLASTIC SURGERY, LLC
NPI 1073224416
Clinic/Center - Medical Specialty in Greenville, SC

Active since December 07, 2022CLIA 42D2289588 · Waiver
107 MILLS AVE, GREENVILLE, SC 29605(864) 990-4240 Get Directions Write a Review

NPPES record last updated: December 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Greenville Facial Plastic Surgery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREENVILLE FACIAL PLASTIC SURGERY, LLC (NPI 1073224416) is a healthcare organization registered as a medical specialty in Greenville, South Carolina and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through September 12, 2027 and lists Katherine Hicks, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1073224416
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameGREENVILLE FACIAL PLASTIC SURGERY, LLC
Location Address107 MILLS AVEGreenville, SC 29605-4017
Mailing Address37 Douglas DrGreenville, SC 29605-1207 · (864) 275-8333
Organization SubpartNo
Authorized OfficialKatherine HicksPhysician/owner · (864) 990-4240
Enumeration DateDecember 7, 2022
NPPES CertifiedDecember 1, 2022
NPI 1073224416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

107 MILLS AVE, Greenville, SC 29605

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2289588

Greenville Facial Plastic Surgery · Greenville, SC
Active · expires Sep 12, 2027
CLIA Number42D2289588
Laboratory TypeOffice Dased Surgery
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorDr. Katherine E. Hicks
Laboratory Phone(864) 990-4240
Laboratory LocationGreenville Facial Plastic Surgery914 Pendleton Street, Suite 100, Greenville, SC 29601
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
107 MILLS AVE
GREENVILLE, SC 29605
Otolaryngology (Facial Plastic Surgery)
107 MILLS AVE
GREENVILLE, SC 29605

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Greenville Facial Plastic Surgery, LLC's NPI number?

The NPI number for Greenville Facial Plastic Surgery, LLC is 1073224416. It was assigned to this organization in the NPPES registry on December 7, 2022.

Where is Greenville Facial Plastic Surgery, LLC located?

Greenville Facial Plastic Surgery, LLC is located at 107 Mills Ave, Greenville, SC 29605. The listed phone number is (864) 990-4240.

What is Greenville Facial Plastic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Greenville Facial Plastic Surgery, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2289588) is associated with this NPI, valid through September 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Greenville Facial Plastic Surgery, LLC was last updated on December 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.