Prisma Health Ambulatory Surgery Centers-Midlands, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC

Doing business as

Prisma Health Plastic Surgery & Aesthetics Pavilion

Practice address

209 Patewood Dr Ste 300
Greenville, SC 29615-3592

Phone

(864) 522-6700

Fax

(864) 522-6705

NPI assigned

Dec 12, 2023

Last updated

Nov 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Polly H Miller

Title

SVP-Fin, Enterprise Payor Contract

Phone

(864) 522-2286

Specialties & licenses 1

Addresses

Other names 1

• Prisma Health Plastic Surgery & Aesthetics Pavilion Doing business as

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1740058551",
    "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": "209 PATEWOOD DR STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153592",
            "telephone_number": "864-522-6700",
            "fax_number": "864-522-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SVP-FIN, ENTERPRISE PAYOR CONTRACT",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Plastic Surgery & Aesthetics Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abbey Louise Princell, PA-C
• Mark H Princell, MD
• Sarah Prindle
• Christina Marie Pringle, RN
• Megan Ashley Prior, AG-ACNP
• Prisma Health Home Recovery Care, LLC
• Prisma Health Imaging Centers, LLC (Prisma Health Imaging Center Orchard Park)
• Prisma Health Surgery Center - Patewood LLC
• Prisma Health University Medical Group
• Prisma Health University Medical Group (University Medical Group/Mobile Health Clinic)

• Ambulatory Surgical Clinic/Center in Greenville, SC
• Providers in Greenville, SC by specialty
• Ambulatory Surgical Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.