Provider Demographics
NPI:1144828468
Name:IVY HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:IVY HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ CO-OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:BELTON-GAYMON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP B-C
Authorized Official - Phone:803-260-3679
Mailing Address - Street 1:100 OLD CHEROKEE ROAD STE F BOX 365
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072
Mailing Address - Country:US
Mailing Address - Phone:803-260-3679
Mailing Address - Fax:
Practice Address - Street 1:4100 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-5800
Practice Address - Country:US
Practice Address - Phone:803-260-3679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty