NPIMap

Organization Active NPI

Prisma Health Medical Group-Midlands

  • Orthopaedic Surgery Physician
  • Columbia, SC
National Provider Identifier
1346761897
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Practice address
14 Richland Medical Park Dr Ste 200
Columbia, SC 29203-6882
Phone
(803) 296-9200
Fax
(803) 296-9297
NPI assigned
Jul 5, 2017
Last updated
Jun 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 200
Columbia, SC 29203-6882

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other identifiers 3

IdentifierTypeStateIssuer
7660520001OtherSCDME MEDICARE PTAN
GP8162MedicaidSC
DE3832OtherSCDME MEDICAID

Other names 1

  • PH Medical Group Midlands Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

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
This NPI is an additional NPI on the enrollment

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

9 Richland Medical Park Dr
Ste 410
Columbia, SC 29203
Phone (803) 254-0670

1830 Pondfield Rd
Ste A1
Newberry, SC 29108
Phone (803) 405-7140

2100 College St
Newberry, SC 29108
Phone (803) 321-3327

Practitioners & affiliated clinicians

Practitioners 83

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 83

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1346761897",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036882",
            "telephone_number": "803-296-9200",
            "fax_number": "803-296-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH MEDICAL GROUP-MIDLANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "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": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICARE PTAN",
            "identifier": "7660520001",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP8162",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICAID",
            "identifier": "DE3832",
            "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 Jun 24, 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.