GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
NPI 1275963175
Clinic/Center - Primary Care in Greenville, SC
About Greenville Age Management Medical Institute, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC (NPI 1275963175) is a healthcare organization registered as a primary care in Greenville, South Carolina and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through March 6, 2027 and lists Marcela Young, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Greenville Age Management Medical Institute, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Greenville Age Management Medical Institute, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 42D2021153
Greenville Age Management Medical Institute · Greenville, SCFrequently 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 Age Management Medical Institute, LLC's NPI number?
The NPI number for Greenville Age Management Medical Institute, LLC is 1275963175. It was assigned to this organization in the NPPES registry on November 14, 2013.
Where is Greenville Age Management Medical Institute, LLC located?
Greenville Age Management Medical Institute, LLC is located at 540 Old Howell Rd, Greenville, SC 29615. The listed phone number is (864) 365-0100.
What is Greenville Age Management Medical Institute, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Greenville Age Management Medical Institute, LLC enrolled in Medicare?
Yes. Greenville Age Management Medical Institute, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Greenville Age Management Medical Institute, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Greenville Age Management Medical Institute, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Greenville Age Management Medical Institute, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2021153) is associated with this NPI, valid through March 6, 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 Age Management Medical Institute, LLC was last updated on November 14, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Greenville Age Management Medical Institute, Llc · NPI 1275963175
Primary Care organization in Greenville, South Carolina. Organization record, active in the CMS NPPES registry since November 14, 2013.
## Identity
- **NPI:** 1275963175 (Entity type: Organization)
- **Enumerated:** November 14, 2013
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Marcela Young, OWNER
## Practice location
- **Address:** 540 OLD HOWELL RD, Greenville, SC 29615-1969
- **Phone:** (864) 365-0100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 14, 2013
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1275963175) · Data from the CMS NPPES public registry.