NPIMap

Individual provider Active NPI

Miesty Woodburn, M.D.

  • Neurology Physician
  • Greenville, SC
National Provider Identifier
1295122000
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
89737 Issued in SC
Practice address
200 Patewood Dr Ste B350
Greenville, SC 29615-6337
Phone
(864) 454-4500
Fax
(864) 454-4505
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 89737 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B350
Greenville, SC 29615-6337

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC, SC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200820002641 CA Practitioner - Neurology 7618281577 Reassigns benefits to 1 organization
I20201216001655 NC Practitioner - Neurology 7618281577
I20231102003327 SC Practitioner - Neurology 7618281577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

200 Patewood Dr
Suite B350
Greenville, SC 29615-6337
Phone (864) 454-4500

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89737SCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 21, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 21, 2023 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Telehealth Specialty Medical Group CurrentSince May 19, 2020 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Cornerstone Health Care LLC Past Accepting new patients

Locations

3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628

3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

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

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Ste B350
Greenville, SC 29615
Phone (864) 454-4500

109 Physicians Dr
Ste C
Greer, SC 29650
Phone (864) 797-8800

Interoperability endpoints

  • Direct secure messaging: mwoodburn731171@direct.ghs.myhfn.org

Organizations & group practices 6

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.

Hospital & facility affiliations 58

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1295122000",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B350",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156337",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURN",
        "first_name": "MIESTY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "89737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.