NPIMap

Individual provider Active NPI

Krystal Southerlin White, M.D.

  • Obstetrics & Gynecology Physician
  • Greer, SC
National Provider Identifier
1578723441
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
30989 Issued in SC
Practice address
325 Medical Pkwy Ste 100
Greer, SC 29650-2458
Phone
(864) 797-9200
Fax
(864) 797-9245
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30989 SC Primary

Addresses

Primary practice location

325 Medical Pkwy Ste 100
Greer, SC 29650-2458

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
309892MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwhite170452@direct.ghs.myhfn.org Direct

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
I20120802000387 SC Practitioner - Obstetrics/Gynecology 7315193687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

325 Medical Pkwy
Suite 100
Greer, SC 29650-2458
Phone (864) 797-9200

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30989SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 10, 2017 Accepting new patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Jul 10, 2017 Accepting new patients
Prisma Health-Upstate Past Accepting new patients

Locations

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

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

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

325 Medical Pkwy
Ste 100
Greer, SC 29650
Phone (864) 797-9200

Interoperability endpoints

  • Direct secure messaging: kwhite170452@direct.ghs.myhfn.org

Organizations & group practices 3

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1578723441",
    "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": "325 MEDICAL PKWY STE 100",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502458",
            "telephone_number": "864-797-9200",
            "fax_number": "864-797-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KRYSTAL",
        "middle_name": "SOUTHERLIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "30989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309892",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwhite170452@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kwhite170452@direct.ghs.myhfn.org",
            "address_1": "325 Medical Pkwy Ste 100",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296502458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.