NPIMap

Individual provider Active NPI

Christina S Gutta, MD

  • Sports Medicine (Family Medicine) Physician
  • Greenville, SC
National Provider Identifier
1558715896
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
82428 Issued in SC
Practice address
200 Patewood Dr Ste C100
Greenville, SC 29615-6322
Phone
(864) 454-7422
Fax
(864) 454-8265
NPI assigned
Apr 22, 2016
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 82428 SC
Family Medicine Physician 207Q00000X TRN22658 FL
Sports Medicine (Family Medicine) Physician 207QS0010X 20-82428 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 82428 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste C100
Greenville, SC 29615-6322

Mailing address

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

Other practice location 1

905 Verdae Blvd Ste 101
Greenville, SC 29607-4029
Phone (864) 286-7550

Other identifiers 1

IdentifierTypeStateIssuer
824282MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christina.gutta@prismahealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200831002115 SC Practitioner - Sports MedicinePractitioner - Family Practice 2062787849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of South Carolina School of Medicine, Greenville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

905 Verdale Blvd
Suite 101
Greenville, SC 29607-4029
Phone (864) 286-7550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN22658FLMDFamily Medicine Physician
20-82428SCMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 23, 2020 Accepting new patients
Prisma Health University Medical Group Family Medicine CurrentSince Aug 23, 2020 Accepting new patients

Locations

22725 Highway 76 E
Ste A
Clinton, SC 29325
Phone (864) 833-4545

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

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

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

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

905 Verdae Blvd
Ste 101
Greenville, SC 29607
Phone (864) 286-7550

727 SE Main St
Ste 220
Simpsonville, SC 29681
Phone (864) 454-6600

Interoperability endpoints

  • Direct secure messaging: cgutta244006@direct.ghs.myhfn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1558715896",
    "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 C100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156322",
            "telephone_number": "864-454-7422",
            "fax_number": "864-454-8265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 Verdae Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296074029",
            "country_code": "US",
            "telephone_number": "864-286-7550",
            "fax_number": "864-286-7551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTTA",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "82428",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN22658",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "20-82428",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "82428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824282",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christina.gutta@prismahealth.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "905 Verdae Blvd Ste 101",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296074029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.