Individual provider Active NPI

Laurie Lynn Malmstrom, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Greenville, SC
National Provider Identifier
1093732091
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
21139 Issued in SC
Practice address
701 Grove Rd
GMH ER Administration
Greenville, SC 29605-5611
Phone
(864) 455-6372
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 21139 SC Primary

Addresses

Primary practice location

701 Grove Rd
GMH ER Administration
Greenville, SC 29605-5611

Mailing address

255 Enterprise Blvd
Suite 250
Greenville, SC 29615-6300
Phone (864) 454-0888

Other identifiers 8

IdentifierTypeStateIssuer
211390MedicaidSC
57-6007863OtherSCBCBS
57-6007863OtherSCBLUE CHOICE
57-6007863OtherSCTRICARE
167193OtherSCUNISON
930081471OtherSCMEDICARE RAILROAD
20-21139OtherSCSCCS
20004419OtherSCSELECT HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000810 SC Practitioner - Emergency Medicine 9739364753 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21139SCMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Greenville PA Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 1, 2017 Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2016 Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

255 Enterprise Blvd
Ste 250
Greenville, SC 29615
Phone (864) 454-0886

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: lmalmstrom16538@direct.ghs.myhfn.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093732091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156300",
            "telephone_number": "864-454-0888",
            "fax_number": "864-454-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "address_2": "GMH ER ADMINISTRATION",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055611",
            "telephone_number": "864-455-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMSTROM",
        "first_name": "LAURIE",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "SC",
            "license": "21139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211390",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "167193",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930081471",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCCS",
            "identifier": "20-21139",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "20004419",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.