NPIMap

Organization Active NPI

Greenville Health Corporation

Doing business as Prisma Health Center for Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
National Provider Identifier
1629405246
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
GREENVILLE HEALTH CORPORATION
Doing business as
Prisma Health Center for Prosthetics & Orthotics
Practice address
50 Bear Dr
Greenville, SC 29605-4458
Phone
(864) 522-3880
Fax
(864) 522-3889
NPI assigned
Sep 27, 2013
Last updated
Jul 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Polly H. Miller
Title
SVP Finance, Enterprise Contracting
Phone
(864) 522-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

50 Bear Dr
Greenville, SC 29605-4458

Mailing address

50 Bear Dr
Greenville, SC 29605-4458

Other identifiers 2

IdentifierTypeStateIssuer
0306710005OtherSCMEDICARE PTAN
DE3514MedicaidSC

Other names 1

  • Prisma Health Center for Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140109000641 SC DME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Orthotic Personnel 4789644212 Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Greenville Health Corporation50 Bear Dr, Greenville, SC 29605-4458(864) 522-3880 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2005

National Provider Directory

National Provider Directory
Tax ID family
Urgent Treatment Center24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

50 Bear Dr
Greenville, SC 29605
Phone (864) 241-6222

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1629405246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-522-3880",
            "fax_number": "864-522-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SVP FINANCE, ENTERPRISE CONTRACTING",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0306710005",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE3514",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Center for Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.