NPIMap

Organization Active NPI

Prisma Health-Upstate

Doing business as Prisma Health Laurens Family Med-Gray Ct

  • Multi-Specialty Clinic/Center
  • Gray Court, SC
National Provider Identifier
1194405969
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PRISMA HEALTH-UPSTATE
Doing business as
Prisma Health Laurens Family Med-Gray Ct
Practice address
9100 Highway 14
Gray Court, SC 29645-4152
Phone
(864) 522-2286
NPI assigned
Jul 18, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Polly H. Miller
Title
SVP Fin Enterprise Contracting
Phone
(864) 522-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

9100 Highway 14
Gray Court, SC 29645-4152

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-2286

Other names 1

  • Prisma Health Laurens Family Med-Gray Ct Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PH Oconee Memorial Hospital121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1194405969",
    "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": "864-522-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 HIGHWAY 14",
            "city": "GRAY COURT",
            "state": "SC",
            "postal_code": "296454152",
            "telephone_number": "864-522-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH-UPSTATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SVP FIN ENTERPRISE CONTRACTING",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Laurens Family Med-Gray Ct",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prisma Health Laurens Family Med-Gray Ct",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gray Court, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.