Upstate Prosthetics LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

023091440 Issued in SC

Legal business name

UPSTATE PROSTHETICS LLC

Practice address

742 Congaree Rd
Greenville, SC 29607-3520

Phone

(864) 288-4150

Fax

(864) 288-4149

NPI assigned

Jan 23, 2012

Last updated

Sep 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Sanders

Title

Owner

Phone

(864) 288-4150

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1205107208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 CONGAREE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073520",
            "telephone_number": "864-288-4150",
            "fax_number": "864-288-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 CONGAREE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073520",
            "telephone_number": "864-288-4150",
            "fax_number": "864-288-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-288-4150"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "023091440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Greenville, SC
• Providers in Greenville, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.