PRISMA HEALTH MEDICAL GROUP-MIDLANDS


Address: 3304 Forest Dr, Columbia, SC 29204-4024
Phone: 8034346565

PRISMA HEALTH MEDICAL GROUP-MIDLANDS (NPI# 1295222503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295222503
Entity Type Organization
Organization Name PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Other Organization Name PH MEDICAL GROUP MIDLANDS
Practice Address 3304 Forest Dr
Columbia
SC 29204-4024
Mailing Address Po Box 743904
Atlanta
GA 30374-3904
Practice Telephone 8034346565
Practice Fax Number 8034346299
Mailing Telephone 8032967320
Mailing Fax Number 8032967330
Enumeration Date 2018-04-23
Last Update Date 2020-07-16
Authorized Official Name KRISTI LAWRENCE (DIRECTOR PROVIDER ENROLLMENT)
Authorized Official Telephone 8647976118
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204E00000X Oral & Maxillofacial Surgery Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC ZA8923 05

Other Provider/Organization Names

Other Name Type Code
PH Medical Group Midlands Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1518455252 Prisma Health Medical Group-midlands Orthopaedic Surgery 100 N Sumter St Ste 200, Sumter, SC 29150-4975 2018-04-27
1992226534 Prisma Health Medical Group-midlands Orthopaedic Surgery 101 Business Park Blvd Fl 2, Columbia, SC 29203-8401 2017-07-05
1538680004 Prisma Health Medical Group-midlands Orthopaedic Surgery 300 Palmetto Health Pkwy Ste 200, Columbia, SC 29212-1762 2017-07-05
1255852901 Prisma Health Medical Group-midlands Orthopaedic Surgery 100 Palmetto Health Pkwy Ste 320, Columbia, SC 29212-1756 2017-07-03
1285678078 Prisma Health Medical Group-midlands Pediatrics 9 Richland Medical Park Dr Ste 410, Columbia, SC 29203-6859 2006-06-15
1417442864 Prisma Health Medical Group-midlands Dentist 10 Richland Medical Park Dr Ste A, Columbia, SC 29203-6892 2018-06-28
1003307166 Prisma Health Medical Group-midlands Internal Medicine 8 Richland Medical Park Dr Ste 300, Columbia, SC 29203-8008 2018-05-24
1447749510 Prisma Health Medical Group-midlands Family Medicine 115 N Sumter St Ste 115, Sumter, SC 29150 2018-05-04
1457848848 Prisma Health Medical Group-midlands Pediatrics 9 Richland Medical Park Dr Ste 210, Columbia, SC 29203-6859 2018-04-20
1871080283 Prisma Health Medical Group-midlands Hospitalist 115 N Sumter St Ste 400, Sumter, SC 29150-4971 2018-04-20

Office Location

Street Address 3304 FOREST DR
City COLUMBIA
State SC
Zip Code 29204-4024

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427121078 Joseph John Krupa IIi Dentist 3304 Forest Dr, Columbia, SC 29204-4024 2006-11-15
1568877439 Maxine Myers Nurse Practitioner 3304 Forest Dr, Columbia, SC 29204-4024 2014-06-30
1740626621 Jmp Family Practice Incorporated Clinic/Center 3304 Forest Dr, Columbia, SC 29204-4024 2013-05-17
1740590157 Forest Drive Physicians Clinic/Center 3304 Forest Dr, Columbia, SC 29204-4024 2010-10-19
1104135763 Ja-rem Enterprises Clinic/Center 3304 Forest Dr, Columbia, SC 29204-4024 2010-09-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992215149 Ricardo Colon II Registered Nurse 3000 Hampton Street, Columbia, SC 29204 2017-10-02
1780113522 Carla Star Noe Registered Nurse Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 2017-06-06
1124568514 Kristy L Thompson Nurse Practitioner 1655 Bernardin Ave Ste 240, Columbia, SC 29204 2017-03-03
1982052031 Harold Eugene Cook Iv Podiatrist 1730 St Julian Place, Columbia, SC 29204 2016-05-31
1851748974 Shaquita Banks Counselor 1810 Allen Benedict Ct, A1, Columbia, SC 29204 2016-05-18
1265804835 Premier Care, LLC Case Management 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 2015-10-22
1023492287 Shamiquia N. Mcpherson Counselor 1627 Auburn St., Columbia, SC 29204 2015-07-16
1285028449 The Columbia Free Medical Clinic, Inc. Clinic/Center 1875 Harden Street, Columbia, SC 29204 2015-03-26
1629473459 Leslie Wilson Counselor 2323 Lady Street, Columbia, SC 29204 2014-10-22
1053728683 Candyce Sutton Social Worker 1135 Carter Street, Columbia, SC 29204 2014-07-15
Find all providers in zip 29204

Taxonomy Information

Taxonomy Code 204E00000X
Grouping Allopathic & Osteopathic Physicians
Classification Oral & Maxillofacial Surgery

Taxonomy Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366889479 Eric J Wu Oral & Maxillofacial Surgery 5900 Waterloo Rd Ste 220, Columbia, MD 21045-2638 2013-05-30
1043542988 Central Maryland Oral and Maxillofacial Surgery P.a. Oral & Maxillofacial Surgery 10710 Charter Dr, Suite 330, Columbia, MD 21044-3128 2010-02-03
1477881290 Domenick Coletti Dds, Md, PC Oral & Maxillofacial Surgery 10710 Charter Dr, Suite 330, Columbia, MD 21044-3128 2009-12-07
1720071236 Domenick Peter Coletti Oral & Maxillofacial Surgery 10710 Charter Dr, Suite 330, Columbia, MD 21044-3128 2005-08-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437763661 Charleston Jaw Surgery Oral & Maxillofacial Surgery 846 St. Andrews Blvd., Charleston, SC 29407 2020-09-04
1265930697 Palmetto Ofs, LLC Oral & Maxillofacial Surgery 2849 N Pleasantburg Dr, Greenville, SC 29609-3034 2018-01-31
1730602319 Shelbourne & Associates Oral and Facial Surgery Oral & Maxillofacial Surgery 198 Rutledge Ave Ste 4, Charleston, SC 29403-5834 2017-07-25
1861913022 Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa Oral & Maxillofacial Surgery 1761 Ebenezer Road, Rock Hill, SC 29732 2017-06-28
1659543148 Robert L. Coles, Dmd Oral & Maxillofacial Surgery 15b Winchester Ct, Mauldin, SC 29662-2626 2008-03-25
1174666283 Leonard Edward Mcgaha Oral & Maxillofacial Surgery 1514 N Fant St, Anderson, SC 29621-4708 2007-02-15
1376642710 Harry Clinton Belk Jr. Oral & Maxillofacial Surgery 115 Powell Mill Road, Spartanburg, SC 29301 2006-09-22
1912019001 Jonna J Moreschi Oral & Maxillofacial Surgery 1021 Maxwell Mill Road, Suite #e, Fort Mill, SC 29708 2006-08-31
1790720043 James B Tankersley Jr. Oral & Maxillofacial Surgery 4103 E North St, Greenville, SC 29615 2006-06-19
1588629638 Philip M Prickett Oral & Maxillofacial Surgery 1311 Chuck Dawley Blvd, Suite 101, Mt Pleasant, SC 29464-7303 2006-04-20
Find all providers with the same taxonomy

Competitor

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City COLUMBIA
Zip Code 29204

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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