PRISMA HEALTH UNIVERSITY MEDICAL GROUP (NPI# 1578890273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578890273 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH UNIVERSITY MEDICAL GROUP |
| Other Organization Name | UNIVERSITY MEDICAL GROUP |
| Practice Address |
200 Patewood Dr Suite A200 Greenville SC 29615-3593 |
| Mailing Address |
7 Independence Pt Ste 140 Greenville SC 29615-4550 |
| Practice Telephone | 8644545115 |
| Mailing Telephone | 8643854790 |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | KRISTI ANN LAWRENCE (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8647976118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DEC300 | 05 | |
| SC | DRC010 | 05 | |
| SC | SELECT HEALTH ID NUMBER | 20032744 | 01 |
| Other Name | Type Code |
|---|---|
| University Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1730786096 | Prisma Health University Medical Group | Radiology | 1519 Marion St, Columbia, SC 29201-2910 | 2020-10-08 |
| 1114542081 | Prisma Health University Medical Group | Health Educator | 712 Grove Rd, Greenville, SC 29605-4211 | 2020-06-16 |
| 1295218642 | Prisma Health University Medical Group | Internal Medicine | 106 John St, Easley, SC 29640-1415 | 2018-09-12 |
| 1619411899 | Prisma Health University Medical Group | Durable Medical Equipment & Medical Supplies | 109 Fleetwood Dr, Suite B, Easley, SC 29640-2019 | 2016-12-07 |
| 1225480486 | Prisma Health University Medical Group | Pediatrics | 208 Frontage Rd, Suite 1, Clemson, SC 29631-1691 | 2016-07-12 |
| 1265884852 | Prisma Health University Medical Group | Durable Medical Equipment & Medical Supplies | 333 S Pine St, Spartanburg, SC 29302-2622 | 2016-07-07 |
| 1053786483 | Prisma Health University Medical Group | Nurse Practitioner | 701 Grove Rd, Greenville, SC 29605-4210 | 2015-12-10 |
| 1558754978 | Prisma Health University Medical Group | Orthopaedic Surgery | 10630 Clemson Blvd, Suite 100, Seneca, SC 29678-4546 | 2015-03-10 |
| 1528465374 | Prisma Health University Medical Group | Anesthesiology | 67 Creekside Park Ct, Greenville, SC 29615-4810 | 2014-11-21 |
| Street Address |
200 PATEWOOD DR SUITE A200 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29615-3593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508861345 | John Kim Johnson | Neurological Surgery | 200 Patewood Dr, Suite B260, Greenville, SC 29615-3593 | 2005-06-17 |
| 1255941241 | Sharmaine Barnes | Specialist/Technologist | 200 Patewood Dr, Greenville, SC 29615-3593 | 2020-08-04 |
| 1598320897 | Yana Ginzburg | Physical Therapist | 200 Patewood Dr, Greenville, SC 29615-3593 | 2019-05-02 |
| 1457891228 | Sierra R Williams | Nurse Practitioner | 200 Patewood Dr, Suite B260, Greenville, SC 29615-3593 | 2017-02-27 |
| 1063951333 | Megan Lee Hiott | Nurse Practitioner | 200 Patewood Dr, A330, Greenville, SC 29615-3593 | 2017-02-19 |
| 1316485394 | Anita Suzette Combs | Nurse Practitioner | 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 | 2017-02-09 |
| 1730626813 | Lauren Lee Hays | Nurse Practitioner | 200 Patewood Dr, Suite B350, Greenville, SC 29615-3593 | 2017-01-26 |
| 1497200083 | Abigail Pellett | Physical Therapist | 200 Patewood Dr, Ste C150, Greenville, SC 29615-3593 | 2016-08-24 |
| 1033664909 | Prisma Health-upstate | General Acute Care Hospital | 200 Patewood Dr, Suite C300, Greenville, SC 29615-3593 | 2016-08-22 |
| 1144775032 | Prisma Health-upstate | General Acute Care Hospital | 200 Patewood Dr, Building A, Greenville, SC 29615-3593 | 2016-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
| 1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
| 1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
| 1255816070 | Trevis L Cureton | Pharmacist | 2401 East North St, Greenville, SC 29615 | 2018-09-27 |
| 1497232565 | Jacob J Fountain | Nurse Practitioner | 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 | 2018-07-23 |
| 1346726924 | St. Francis Physician Services, Inc | Internal Medicine | 5 Hoke Smith Blvd, Greenville, SC 29615 | 2018-07-17 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1316466543 | Mariah Hope Mosher | Behavioral Analyst | 7 Mckenna Commons Court, Greenvilee, SC 29615 | 2017-09-19 |
| 1326400896 | Karen L Heaps | Counselor | 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 | 2016-03-24 |
| 1134589013 | Sharon Erk | Technician, Other | 2950 E.norths St, Greenville, OH 29615 | 2016-03-04 |
| Find all providers in zip 29615 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518917061 | Rae Lynne Hornsby | Pediatrics | 142 Milestone Way, Greenville, SC 29615-5065 | 2006-05-12 |
| 1841644077 | Sara Elizabeth Lilly | Pediatrics | 701 Grove Rd Fl 5, Greenville, SC 29605-4210 | 2016-04-13 |
| 1477872810 | Caroline Black Buchanan | Pediatrics | 14 Edgewood Dr, Greenville, SC 29605-4246 | 2010-05-25 |
| 1831318856 | Greenwood Genetics Center, Inc. | Pediatrics | 14 Edgewood Dr, Greenville, SC 29605-4246 | 2007-04-25 |
| 1154474385 | Alfred Quinn Scheuer | Pediatrics | 925 Conference Dr, Greenville, NC 27858-5971 | 2007-01-19 |
| 1710042387 | Susan Downer Foreman | Pediatrics | 925 Conference Dr, Greenville, NC 27858-5971 | 2006-12-26 |
| 1841399599 | Luis F. Marti-calzamilia | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2006-09-21 |
| 1215969167 | Tara Ann Cancellaro | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2006-07-07 |
| 1295787844 | Desmond Peyton Kelly | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2006-05-16 |
| 1093765497 | James Harold Beard Jr. | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2006-05-10 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29615 |
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| 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.