PRISMA HEALTH-UPSTATE (NPI# 1043857998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043857998 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH-UPSTATE |
| Other Organization Name | PRISMA HEALTH FAMILY MEDICINE-WALHALLA |
| Practice Address |
103 Whitetail Dr Walhalla SC 29691-5837 |
| Mailing Address |
1 Independence Pt Ste 212 Greenville SC 29615-4536 |
| Practice Telephone | 8646383444 |
| Practice Fax Number | 8646383445 |
| Mailing Telephone | 8647976307 |
| 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 Family Medicine-Walhalla | 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 |
| 1932746815 | Prisma Health-upstate | Clinic/Center | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 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 |
103 WHITETAIL DR |
| City | WALHALLA |
| State | SC |
| Zip Code | 29691-5837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699759217 | William Strother Darby | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2005-12-06 |
| 1902351190 | Keri Marlene Dickson | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-08-17 |
| 1669820726 | Sherri Mcmahan | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-05-31 |
| 1881057644 | Britta Ann Johnson | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-03-30 |
| 1093197980 | Michael Stephen Odom | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691 | 2015-06-26 |
| 1154703783 | Sarah Caroline Fabry | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691 | 2015-06-19 |
| 1467891895 | Ronni Ayala | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2013-06-19 |
| 1366530768 | Teresa Lynn Brown | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2006-10-11 |
| 1770519209 | Susan H Curtis | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598970097 | Steven Syck | Rehabilitation Hospital | 112 Falcons View Ct., Walhalla, SC 29691 | 2007-05-10 |
| 1710093281 | Sidney R Bryson Dmd Pa | Dentist | 107 N Earle St, Walhalla, SC 29691 | 2006-08-21 |
| 1578515649 | School District of Oconee County | Local Education Agency (LEA) | 414 S Pine St, Walhalla, SC 29691 | 2006-05-17 |
| 1295782290 | Robert Edward Lawson Iv | Chiropractor | 206 W Main St, Walhalla, SC 29691 | 2006-05-27 |
| 1770995953 | Linda Smith | Licensed Practical Nurse | 151 Razorback Ln, Walhalla, SC 29691-1624 | 2014-05-22 |
| 1245676824 | Alison Crocker Chiles | Registered Nurse | 177 Razorback Ln, Walhalla, SC 29691-1624 | 2013-05-22 |
| 1669810388 | Pearl Reese | Licensed Practical Nurse | 225 Coffee Rd, 225 Coffee Road, Walhalla, SC 29691-1777 | 2013-06-05 |
| 1508482555 | Maria Kraayeveld | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2020-06-24 |
| 1063930782 | Opal Anna Farwell | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2017-09-01 |
| 1942609854 | Laurie Vanderwiele | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2014-08-15 |
| Find all providers in zip 29691 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497815310 | Cavalier County Memorial Hospital Association | Clinic/Center | 301 5th St, Walhalla, ND 58282-4625 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482050 | The Palmetto Clinics, LLC | Clinic/Center | 463 Calhoun Ave Ste A-2, Greenwood, SC 29649-2063 | 2020-06-21 |
| 1962969154 | The Palmetto Palace | Clinic/Center | 217 Flat St E, Allendale, SC 29810-4647 | 2019-02-25 |
| 1972014652 | Mcleod Physician Associates II | Clinic/Center | 1040 Marlboro Way Ste 1, Bennettsville, SC 29512-2494 | 2017-10-20 |
| 1508377284 | Mcleod Physician Associates II | Clinic/Center | 1076 Marlboro Way Ste 3, Bennettsville, SC 29512-2495 | 2017-10-20 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1043602428 | Greenville Health System | Clinic/Center | 208 Frontage Rd Ste 1, Clemson, SC 29631-1671 | 2015-02-23 |
| 1114204153 | Mcleod Physician Associates II | Clinic/Center | 5260 Highway 9, Green Sea, SC 29545-4930 | 2011-11-04 |
| 1700160157 | Mackey Family Practice, Pa | Clinic/Center | 8351 Charlotte Hwy, Suite 200, Indian Land, SC 29707-6552 | 2011-10-04 |
| 1588943021 | Edisto Regional Health Services Inc. | Clinic/Center | 185 Mcgee St, Bamberg, SC 29003-1154 | 2011-08-16 |
| 1124307509 | Coastal Carolina Medical Center, Inc | Clinic/Center | 10911 N Jacob Smart Blvd, D, Ridgeland, SC 29936-2729 | 2011-08-16 |
| Find all providers with the same taxonomy | ||||
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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.