Individual provider Active NPI

Kimberly Elliott Sadri, RN

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1750893277
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21426 Issued in SC
Practice address
320 W Stone Ave
Greenville, SC 29609-5437
Phone
(864) 203-3636
Fax
(864) 341-2001
NPI assigned
Oct 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 103182 SC
Nurse Practitioner 363L00000X 21426 SC Primary

Addresses

Primary practice location

320 W Stone Ave
Greenville, SC 29609-5437

Mailing address

320 W Stone Ave
Greenville, SC 29609-5437
Phone (864) 203-3636

Other identifiers 2

IdentifierTypeStateIssuer
NP4820MedicaidSC
SCB7745019OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelliott38902@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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103003280 SC Practitioner - Nurse Practitioner 7618235292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

877 W Faris Rd
Suite B
Greenville, SC 29605-4296
Phone (864) 522-6225

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
103182SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Cannon Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 12, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 12, 2018 Accepting new patients

Locations

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

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

877 W Faris Rd
Ste B
Greenville, SC 29605
Phone (864) 522-6225

1005 Grove Rd
Greenville, SC 29605
Phone (864) 235-7665

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

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

123 Wg Acker Dr
Pickens, SC 29671
Phone (864) 512-2465

Organizations & group practices 4

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1750893277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W STONE AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095437",
            "telephone_number": "864-203-3636",
            "fax_number": "864-341-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W STONE AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095437",
            "telephone_number": "864-203-3636",
            "fax_number": "864-341-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADRI",
        "first_name": "KIMBERLY",
        "middle_name": "ELLIOTT",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "103182",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4820",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCB7745019",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelliott38902@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kelliott38902@direct.ghs.myhfn.org",
            "address_1": "1005 Grove Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.