NPIMap

Organization Active NPI

Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1295763217
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Practice address
2A Cleveland CT
Greenville, SC 29607-2414
Phone
(864) 454-2000
Fax
(864) 797-6210
NPI assigned
Jun 29, 2006
Last updated
Apr 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Kristi Lawrence
Title
Director of Provider Enrollment
Phone
(864) 385-4790

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

2A Cleveland CT
Greenville, SC 29607-2414

Mailing address

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

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000238 SC Part B Supplier - Clinic/Group Practice 8325950983 Receives reassigned benefits from 3,477 practitioners
34 other NPIs on this enrollment
O20201111002234 SC Part B Supplier - Mammography Center 8325950983 Receives reassigned benefits from 5 practitioners
Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
GHS Partners in Health Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations (25 of 44)

1333 Taylor St
Columbia, SC 29201
Phone (803) 296-5914

1333 Taylor St
Ste D
Columbia, SC 29201
Phone (803) 438-3800

109 Fleetwood Dr
#A
Easley, SC 29640
Phone (864) 442-7618

112 John St
Ste 101
Easley, SC 29640
Phone (864) 442-7585

800 N A St
Easley, SC 29640
Phone (864) 855-0001

1020 Grove Rd
Greenville, SC 29605
Phone (864) 455-2300

105 Doctors Dr
Greenville, SC 29605
Phone (864) 797-7060

109 Doctors Dr
Greenville, SC 29605
Phone (864) 797-7035

1120 Grove Rd
Ste B
Greenville, SC 29605
Phone (864) 455-6444

1350 Cleveland St
Greenville, SC 29607
Phone (864) 271-1450

15 Park Creek Dr
Greenville, SC 29605
Phone (864) 271-7761

200 Patewood Dr
Ste A120
Greenville, SC 29615
Phone (864) 454-2670

200 Patewood Dr
Ste A340
Greenville, SC 29615
Phone (864) 454-2750

200 Patewood Dr
Ste B480
Greenville, SC 29615
Phone (864) 454-4200

200 Patewood Dr
Ste C100
Greenville, SC 29615
Phone (864) 454-7422

209 Patewood Dr
Ste 200
Greenville, SC 29615
Phone (864) 234-9900

2905 White Horse Rd
Greenville, SC 29611
Phone (864) 331-0560

3 Butternut Dr
Ste B
Greenville, SC 29605
Phone (864) 241-7272

300 E McBee Ave
Ste 401
Greenville, SC 29601

3907 S Highway 14
Greenville, SC 29615
Phone (864) 234-0226

3911 S Highway 14
Greenville, SC 29615
Phone (864) 297-8890

3917 S Highway 14
Greenville, SC 29615
Phone (864) 522-1360

57 Cross Park Ct
Greenville, SC 29605
Phone (864) 220-7270

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

890 W Faris Rd
Ste 330
Greenville, SC 29605
Phone (864) 233-1112

Practitioners & affiliated clinicians

Practitioners 3,556

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 3,556

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1295763217",
    "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",
            "fax_number": "864-454-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2A CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-454-2000",
            "fax_number": "864-797-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH UNIVERSITY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "864-385-4790"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.