NPIMap

Prisma Health University Medical Group

Organization Active NPI Nurse Practitioner · Greenville, SC

NPI 1053786483 · NPPES record last updated Jun 24, 2025

Key facts

NPI
1053786483
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Practice address
712 Grove Rd
Greenville, SC 29605-4211
Phone
(864) 455-9349
Fax
(864) 522-1428
NPI assigned
Dec 10, 2015
Organization subpart
No

Authorized official

Name
Kristi Ann Lawrence
Title
Director Provider Enrollment
Phone
(864) 385-4790

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Practitioners 325

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 325

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031103000238 SC Part B Supplier - Clinic/Group Practice 8325950983 Receives reassigned benefits from 3,477 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
GHS Partners in Health (34 organizations share this tax ID)

Locations

2400 Boiling Springs Rd
Ste A
Boiling Springs, SC 29316
Phone (864) 599-0731

101 Chapman Hill Rd
Clemson, SC 29631
Phone (864) 653-4071

3911 S Highway 14
Greenville, SC 29615
Phone (864) 297-8890

1011 Frontage Rd
Greenville, SC 29615
Phone (864) 242-4263

900 W Faris Rd
#2
Greenville, SC 29605
Phone (864) 455-8898

2 Memorial Medical Dr
Greenville, SC 29605
Phone (864) 295-4210

200 Patewood Dr
Ste C300
Greenville, SC 29615
Phone (864) 454-2852

1336 Highway 14
Simpsonville, SC 29681
Phone (864) 522-4705

201 E Broad St
Spartanburg, SC 29306
Phone (864) 707-2135

103 Whitetail Dr
Walhalla, SC 29691
Phone (864) 638-2388

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X Yes
Adult Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LA2200X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X
Gerontology Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LG0600X

Addresses

Primary practice location

712 Grove Rd
Greenville, SC 29605-4211

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 385-4790

Other names

  • University Medical Group/Mobile Health Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 24, 2025.

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1053786483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-385-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054211",
            "telephone_number": "864-455-9349",
            "fax_number": "864-522-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH UNIVERSITY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "864-385-4790"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Medical Group/Mobile Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Medical Group/Mobile Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

All providers in Greenville, SC · Nurse Practitioner in South Carolina

Sources for this page

Verify at the official NPI Registry.