GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
NPI 1275963175
Clinic/Center - Primary Care in Greenville, SC

Active since November 14, 2013CLIA 42D2021153 · Waiver
540 OLD HOWELL RD, GREENVILLE, SC 29615(864) 365-0100 Get Directions Write a Review

NPPES record last updated: November 14, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1275963175
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
Location Address540 OLD HOWELL RDGreenville, SC 29615-1969
Mailing Address540 Old Howell RdGreenville, SC 29615-1969
Organization SubpartNo
Authorized OfficialMarcela YoungOwner · (864) 365-0100
Enumeration DateNovember 14, 2013
NPI 1275963175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in SC · 14183
540 OLD HOWELL RD, Greenville, SC 29615

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, SC
Active · expires Mar 6, 2027
CLIA Number42D2021153
Laboratory TypePhysician Office
Certificate Effective DateMarch 7, 2025
Certificate Expiration DateMarch 6, 2027
Laboratory DirectorDr. Marcela V. Young
Laboratory Phone(864) 365-0100
Laboratory LocationGreenville Age Management Medical Institute540 Old Howell Road, Greenville, SC 29615
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Internal Medicine
540 OLD HOWELL RD
GREENVILLE, SC 29615
Nurse Practitioner (Family)
540 OLD HOWELL RD
GREENVILLE, SC 29615
Internal Medicine
540 OLD HOWELL RD
GREENVILLE, SC 29615
Internal Medicine
540 OLD HOWELL RD
GREENVILLE, SC 29615

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 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.

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.