PRISMA HEALTH-UPSTATE (NPI# 1932746815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932746815 |
Entity Type | Organization |
Organization Name | PRISMA HEALTH-UPSTATE |
Other Organization Name | PRISMA HEALTH MOUNTAIN LAKES FAMILY MEDICINE |
Practice Address |
10110 Clemson Blvd Seneca SC 29678-0812 |
Mailing Address |
1 Independence Pt Ste 212 Greenville SC 29615-4536 |
Practice Telephone | 8644823148 |
Practice Fax Number | 8644820505 |
Enumeration Date | 2019-12-10 |
Last Update Date | 2020-04-13 |
Authorized Official Name | POLLY H. MILLER (VP PAYOR STRATEGIES & ALIGNMENT) |
Authorized Official Telephone | 8645222286 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Prisma Health Mountain Lakes Family Medicine | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396207221 | Prisma Health-upstate | Anesthesiology | 905 Verdae Blvd Ste 102, Greenville, SC 29607-4029 | 2019-04-01 |
1760963243 | Prisma Health-upstate | General Acute Care Hospital | 112 John St Ste 104, Easley, SC 29640-1405 | 2018-08-23 |
1578044053 | Prisma Health-upstate | General Acute Care Hospital | 11402 Anderson Rd Ste B, Greenville, SC 29611-7560 | 2018-08-23 |
1790264497 | Prisma Health-upstate | General Acute Care Hospital | 11404 Anderson Rd, Greenville, SC 29611 | 2018-08-13 |
1982159877 | Prisma Health-upstate | Clinic/Center | 741 Se Main St, Simpsonville, SC 29681-3237 | 2016-08-20 |
1205459443 | Prisma Health-upstate | Clinic/Center | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-05-22 |
1174161806 | Prisma Health-upstate | Clinic/Center | 11082 N Radio Station Rd, Seneca, SC 29678-1142 | 2019-12-12 |
1700424439 | Prisma Health-upstate | Clinic/Center | 12016 N Radio Station Rd, Seneca, SC 29678-1143 | 2019-12-12 |
1043857998 | Prisma Health-upstate | Clinic/Center | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2019-12-10 |
1417505694 | Prisma Health-upstate | General Acute Care Hospital | 729 Se Main St, Simpsonville, SC 29681-3218 | 2019-08-30 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Prisma Health-Upstate | 300 E Mcbee Ave Suite 500, Greenville, SC 29601 |
Street Address |
10110 CLEMSON BLVD |
City | SENECA |
State | SC |
Zip Code | 29678-0812 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851363733 | Andrea L Allyn | Internal Medicine | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2006-02-03 |
1053797381 | Elizabeth Ann Cornine | Nurse Practitioner | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2015-08-10 |
1063894590 | Andrew Hagenauer | Family Medicine | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2015-06-21 |
1891104295 | Ghs Partners In Health, Inc. | Internal Medicine | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2014-08-11 |
1942631585 | Krishna Manhar Patel | Nurse Practitioner | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2013-12-09 |
1083956650 | Zara Colon | Physician Assistant | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2013-03-21 |
1053632836 | Kevin Richard Saunders | Family Medicine | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2010-06-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649803313 | Synergy Spine Center, Pa | Pain Medicine | 457 U.S. Highway 123, Suite D, Seneca, SC 29678 | 2020-02-20 |
1437630746 | Greenville Health Corporation | Durable Medical Equipment & Medical Supplies | 10708 Clemson Blvd, Seneca, SC 29678 | 2018-08-24 |
1497233415 | Southern Telco, Inc. | Emergency Response System Companies | 15879 Wells Hwy, Seneca, SC 29678 | 2018-08-01 |
1598252199 | Chana Ashlan Land | Counselor | 530 By Pass 123 Ste E2, Seneca, SC 29678 | 2018-04-18 |
1679972632 | Anesthesia At Synergy Spine | Nurse Anesthetist, Certified Registered | 457 E Bypass 123, Seneca, SC 29678 | 2014-08-15 |
1548683303 | Carolina Counseling Professionals, LLC | Community/Behavioral Health | 123 Loblolly Pine Dr, Seneca, SC 29678 | 2014-01-30 |
1144658170 | Changing Strides Counseling, LLC | Community/Behavioral Health | 123 Loblolly Pine Dr., Seneca, SC 29678 | 2013-10-30 |
1417383811 | Martha Williams | Registered Nurse | 101 Honeybee Ln, Seneca, SC 29678 | 2013-09-18 |
1073867404 | The Upstate's Golden Corner of Psychiatry | Psychiatry & Neurology | 450 B Bypass 123, Seneca, SC 29678 | 2012-11-07 |
1043569916 | Amanda Lee Simpson | Pharmacist | 105 Foothills Center Drive, West Union, SC 29678 | 2012-09-06 |
Find all providers in zip 29678 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154450757 | Blue Ridge Pediatrics LLC | Clinic/Center | 457 B Hwy 123 Bypass, Seneca, SC 29678 | 2007-03-02 |
1174161806 | Prisma Health-upstate | Clinic/Center | 11082 N Radio Station Rd, Seneca, SC 29678-1142 | 2019-12-12 |
1700424439 | Prisma Health-upstate | Clinic/Center | 12016 N Radio Station Rd, Seneca, SC 29678-1143 | 2019-12-12 |
1437605524 | Prisma Health-upstate | Clinic/Center | 109 Omni Dr, Suite B, Seneca, SC 29672-9448 | 2016-08-29 |
1497147870 | Greenville Health System | Clinic/Center | 207 Main St, Seneca, SC 29678-3245 | 2015-02-23 |
1093059214 | Clemson-seneca Pediatrics | Clinic/Center | 207 Main Street, Seneca, SC 29678-3245 | 2012-11-15 |
1104130376 | Blue Ridge Pediatrics LLC | Clinic/Center | 457b Highway 123, Seneca, SC 29678-0842 | 2010-07-30 |
1831375856 | Oconee Physician Practices | Clinic/Center | 109 Omni Dr, Seneca, SC 29672-9448 | 2008-01-22 |
1356527352 | Oconee Physician Practices | Clinic/Center | 106 Ram Cat Aly, Seneca, SC 29678-3244 | 2008-01-21 |
1629049127 | Oconee Pediatrics | Clinic/Center | 15579 Wells Highway, Seneca, SC 29678-4318 | 2006-02-01 |
Find all providers in SENECA |
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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.