NPIMap

Organization Active NPI

Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
National Provider Identifier
1275988321
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
160413-0189 Issued in SC
Legal business name
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Practice address
3555 Harden Street Ext Ste 300
Columbia, SC 29203-6894
Phone
(803) 545-5000
NPI assigned
Apr 26, 2016
Last updated
May 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Kristi Lawrence
Title
Director-Provider Enrollment
Phone
(864) 522-8611

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 160413-0189 SC Primary
Dentist 122300000X SC
Optometrist 152W00000X SC
Emergency Medicine Physician 207P00000X SC
Family Medicine Physician 207Q00000X SC
Internal Medicine Physician 207R00000X SC
Obstetrics & Gynecology Physician 207V00000X SC
Ophthalmology Physician 207W00000X SC
Orthopaedic Surgery Physician 207X00000X SC
Pediatrics Physician 208000000X SC
Neurology Physician 2084N0400X SC
Psychiatry Physician 2084P0800X SC
Surgery Physician 208600000X SC
Urology Physician 208800000X SC
Pain Medicine Physician 208VP0000X SC

Addresses

Primary practice location

3555 Harden Street Ext Ste 300
Columbia, SC 29203-6894

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7033

Other identifiers 2

IdentifierTypeStateIssuer
GP7530MedicaidSC
DA9495MedicaidSC

Other names 1

  • PH Medical Group Midlands Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160802001226 SC Part B Supplier - Clinic/Group Practice 5991099707 Receives reassigned benefits from 1,594 practitioners
7 other NPIs on this enrollment
O20230911002097 SC DME Supplier - Physician - Optometrist 5991099707 Practice locations: Columbia, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Locations (25 of 38)

10 Richland Medical Park Dr
Ste A
Columbia, SC 29203
Phone (803) 434-6565

100 Palmetto Health Pkwy
Ste 250
Columbia, SC 29212
Phone (803) 407-3857

100 Palmetto Health Pkwy
Ste 350
Columbia, SC 29212
Phone (803) 545-5500

1333 Taylor St
Ste 1B
Columbia, SC 29201
Phone (803) 254-6391

1333 Taylor St
Ste 3A
Columbia, SC 29201
Phone (803) 254-4707

1333 Taylor St
Ste 3D
Columbia, SC 29201
Phone (803) 254-5575

14 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-1663

14 Richland Medical Park Dr
Ste 100
Columbia, SC 29203
Phone (803) 434-1260

14 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 252-9907

14 Richland Medical Park Dr
Ste 400
Columbia, SC 29203
Phone (803) 434-7945

1801 Sunset Dr
#200
Columbia, SC 29203

2 Medical Park Rd
Ste 107
Columbia, SC 29203
Phone (803) 434-4480

300 Palmetto Health Pkwy
Ste 400
Columbia, SC 29212

3209 Colonial Dr
Columbia, SC 29203
Phone (803) 434-6113

4 Medical Park Rd
Columbia, SC 29203
Phone (803) 434-2020

6 Richland Medical Park Dr
#2100
Columbia, SC 29203

7 Richland Medical Park Dr
Ste 203
Columbia, SC 29203
Phone (803) 434-3533

7 Richland Medical Park Dr
Ste 215
Columbia, SC 29203
Phone (803) 434-3533

7 Richland Medical Park Dr
Ste 2150
Columbia, SC 29203

7 Richland Medical Park Dr
Ste 7215
Columbia, SC 29203
Phone (803) 434-3533

8 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 254-5038

8 Richland Medical Park Dr
Ste 4
Columbia, SC 29203

8301 Farrow Rd
Columbia, SC 29203
Phone (803) 255-3417

9 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-7606

9 Richland Medical Park Dr
Ste 2
Columbia, SC 29203

Practitioners & affiliated clinicians

Practitioners 1,718

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,718

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1275988321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7033",
            "fax_number": "803-296-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-545-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH MEDICAL GROUP-MIDLANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "DIRECTOR-PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "864-522-8611"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "SC",
            "license": "160413-0189",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7530",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9495",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PH Medical Group Midlands",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.