Upstate Primary Care Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

UPSTATE PRIMARY CARE MEDICINE, LLC

Practice address

810 Powdersville Rd Ste B
Easley, SC 29642-3704

Phone

(864) 551-2764

NPI assigned

Jun 13, 2024

Organization subpart

No

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

Authorized official

Name

Heather Way

Title

Practice Administrator

Phone

(843) 345-0832

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1942043518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 POWDERSVILLE RD STE B",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423704",
            "telephone_number": "864-551-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 POWDERSVILLE RD STE B",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423704",
            "telephone_number": "864-551-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PRIMARY CARE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "WAY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "843-345-0832"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Easley, SC
• Providers in Easley, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.