PRISMA HEALTH UNIVERSITY MEDICAL GROUP (NPI# 1730786096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730786096 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH UNIVERSITY MEDICAL GROUP |
| Practice Address |
1519 Marion St Columbia SC 29201-2910 |
| Mailing Address |
300 E Mcbee Ave Ste 401 Greenville SC 29601-2899 |
| Practice Telephone | 8032965954 |
| Mailing Telephone | 8645228603 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | KRISTI ANN LAWRENCE (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8645228611 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRISMA HEALTH UNIVERSITY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Department of Radiology | 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 |
| 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 |
| 1396141875 | Prisma Health University Medical Group | Optometrist | 104 Simpson St, Greenville, SC 29605-4413 | 2014-11-12 |
| Street Address |
1519 MARION ST |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29201-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639161128 | Frederick W Dreyer IIi | Radiology | 1519 Marion St, Columbia, SC 29201-2910 | 2005-08-19 |
| 1801354782 | John William Brumfield Jr. | Pharmacist | 1519 Marion St, Columbia, SC 29201-2910 | 2019-03-09 |
| 1770096216 | Continuecare Hospital At Palmetto Health Baptist, Inc. | Long Term Care Hospital | 1519 Marion St, Columbia, SC 29201-2910 | 2017-11-07 |
| 1982060570 | Intermedical Hospital of South Carolina | Special Hospital | 1519 Marion St, Columbia, SC 29201-2910 | 2016-01-12 |
| 1336526789 | Jennifer Stephens | Physician Assistant | 1519 Marion St, Columbia, SC 29201-2910 | 2015-05-05 |
| 1548542053 | Sarah Asman Stallings | Physician Assistant | 1519 Marion St, Columbia, SC 29220-4800 | 2011-09-12 |
| 1639499197 | David Timothy Powell | Radiology | 1519 Marion St, Columbia, SC 29201-2910 | 2010-06-08 |
| 1336385616 | Jonathan Eric Botstein | Radiology | 1519 Marion St, Columbia, SC 29220-6220 | 2008-12-17 |
| 1194984096 | Harry Simms Hardin Iv | Radiology | 1519 Marion St, Pitts Radiology, Columbia, SC 29201-2910 | 2008-06-05 |
| 1124066527 | Derek Prainorut Jakes | Radiology | 1519 Marion St, Columbia, SC 29220-0001 | 2006-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049421 | Souzan Moslehshirazi | Behavior Technician | 1320 Main Street Suite 300, Colombia, SC 29201 | 2020-10-02 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1548887128 | Casania's Caring Hands,llc | Home Health Aide | 1113 Belleview Street, 105, Columbia, SC 29201 | 2020-06-30 |
| 1639719909 | Benjamin Clark Watson | Acupuncturist | 1825 Sumter St., Columbia, SC 29201 | 2020-01-14 |
| 1588217574 | Aneika Daley | Specialist/Technologist | 1211 Wheat St, Columbia, SC 29201 | 2019-07-19 |
| 1447803531 | Gillian Taylor Shaughnessy | Specialist/Technologist | 147 South Marion St, Columbia, SC 29201 | 2019-07-18 |
| 1417417619 | Maria Nelson | Behavior Technician | 320 Main St Suite 300, Columbia, SC 29201 | 2019-03-22 |
| 1679041297 | Nathaniel Carl Stocker | Nurse Practitioner | 1614 Main Street, Suite C, Sc House Calls Inc, Columbia, SC 29201 | 2018-11-13 |
| 1558852855 | The Practice | Family Medicine | 1910 Gregg Street, Columbia, SC 29201 | 2018-05-22 |
| 1871095836 | Kadesjah Samuels | Behavior Technician | 1320 Main Street, Suite 300, Columbia, SC 29201 | 2018-03-06 |
| Find all providers in zip 29201 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093200966 | Alexander John Lubinski | Radiology | 1 Hospital Drive Dco6910, Columbia, MO 65212 | 2018-06-24 |
| 1275028136 | Austin Fletcher | Radiology | University Hospital One Hospital Drive, Department of Radiology Dc 069.10, Columbia, MO 65212-0001 | 2018-06-24 |
| 1316467046 | Philip Silva | Radiology | 1 Hospital Drive University of Missouri, Columbia, MO 65212-0001 | 2017-06-23 |
| 1952832859 | Juhi Koolwal | Radiology | 1 Hospital Dirve Ddc06910, Columbia, MO 65212 | 2017-03-22 |
| 1467993386 | Iv Radiology Medical Group | Radiology | 10000 Town Center Ave, Apt 244, Columbia, MD 21044-5418 | 2017-03-10 |
| 1508216920 | David Koch | Radiology | 1 Hospital Drive, Dc06910, Columbia, MO 65212 | 2016-06-16 |
| 1023462439 | Robert Michael Robbins | Radiology | 1 Hospital Drive Columbia Mo 65212, Columbia, MO 65212-4973 | 2016-04-21 |
| 1669836292 | Brian Trissell | Radiology | 1 Hospital Drive Dc069.10, Columbia, MO 65212 | 2016-04-10 |
| 1295104073 | Arthur Knight Walter | Radiology | 737 River Rd, Columbia, SC 29212-8809 | 2015-09-22 |
| 1750765558 | Joel Schmidt | Radiology | 1 Hospital Drive, Dc069.10, Columbia, MO 65212 | 2015-07-13 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on PRISMA HEALTH UNIVERSITY MEDICAL GROUP.
| 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.