# JERVEY EYE GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992775696
- **Authorized official:** BRIAN W SHELLEY MD (PRESIDENT)
- **Authorized official phone:** (864) 458-7956

## Contact information

- **Practice address:** 601 HALTON RD, GREENVILLE, SC 29607-3403
- **Practice address phone:** (864) 458-3900
- **Practice address fax:** (864) 458-8390
- **Mailing address:** 601 HALTON RD, GREENVILLE, SC 29607-3403
- **Mailing address phone:** (864) 458-7956
- **Mailing address fax:** (864) 458-8390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 646 | SC | — |
| 207W00000X | Ophthalmology Physician | 11002 | SC | — |
| 207W00000X | Ophthalmology Physician | 14023 | SC | — |
| 207W00000X | Ophthalmology Physician | 17064 | SC | — |
| 207W00000X | Ophthalmology Physician | 24224 | SC | — |
| 207W00000X | Ophthalmology Physician | 28578 | SC | Yes |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |

## Other

- **Enumeration date:** 01/25/2006
- **Last updated:** 06/23/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CN1548 | MEDICARE RAILROAD | SC |
| 05 | — | DA9934 | — | SC |
| 01 | — | DM0381 | MEDICAID DMERC NUMBER | SC |
| 05 | — | GP0901 | — | SC |