PRISMA HEALTH UNIVERSITY MEDICAL GROUP (NPI# 1295218642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295218642 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH UNIVERSITY MEDICAL GROUP |
| Other Organization Name | UMG EASLEY |
| Practice Address |
106 John St Easley SC 29640-1415 |
| Mailing Address |
1 Independence Pt Ste 212 Greenville SC 29615-4536 |
| Practice Telephone | 8648592220 |
| Practice Fax Number | 8648595744 |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2020-04-29 |
| Authorized Official Name | DAVID WILLIAMS (PRESIDENT) |
| Authorized Official Telephone | 8648339151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UMG Easley | 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 |
| 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 |
106 JOHN ST |
| City | EASLEY |
| State | SC |
| Zip Code | 29640-1415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790737369 | Palmetto Health | Family Medicine | 106 John St, Suite B, Easley, SC 29640-1415 | 2006-05-16 |
| 1457816928 | Elizabeth Lacy | Nurse Practitioner | 106 John St, Easley, SC 29640-1415 | 2019-02-08 |
| 1700326261 | Rippol J Patel | Family Medicine | 106 John St, Easley, SC 29640-1415 | 2017-03-03 |
| 1104368174 | Kathryn Lea Luckett | Nurse Practitioner | 106 John St, Easley, SC 29640-1415 | 2016-11-08 |
| 1962852632 | Nathan Randall Jones | Family Medicine | 106 John St, Easley, SC 29640-1415 | 2016-06-14 |
| 1871997742 | Brittany Ellis | Nurse Practitioner | 106 John St, Easley, SC 29640-1415 | 2014-10-21 |
| 1811327851 | Jeffrey Nations | Family Medicine | 106 John St, Easley, SC 29640-1415 | 2013-11-12 |
| 1700042462 | Natalie R Singleton | Nurse Practitioner | 106 John St, Easley, SC 29640 | 2008-08-01 |
| 1215943386 | Debbie Ellis | Family Medicine | 106 John St, Easley, SC 29640-1415 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063935773 | Mary Kathryn Henderson | Speech-Language Pathologist | 1400 Griffin Mill Road, Easley, SC 29640 | 2017-07-25 |
| 1417309451 | Ashby Park Pediatric Dentistry Easley | Dentist | 708 North A Street, Easley, SC 29640 | 2016-07-01 |
| 1548696990 | Phuong T Tran | Pharmacist | 309 Rolling Hills Circle, Easley, SC 29640 | 2013-09-17 |
| 1538593017 | Baptist Easley Hospital | Clinic/Center | 200 Fleet Wood Dr 3 Rd Floor, Easley, SC 29640 | 2013-09-03 |
| 1942507173 | Joanne Mason Wilkinson | Occupational Therapist | 1807a East Main St, Easley, SC 29640 | 2011-02-24 |
| 1861793911 | Ark Pharmacy Services LLC | Pharmacy | 5119- A Calhoun Memorial Hwy, Easley, SC 29640 | 2010-11-05 |
| 1659507952 | Sarah Elizabeth Proulx | Dentist | 227 South Pendleton Street, Suita A, Easley, SC 29640 | 2009-06-02 |
| 1508030503 | Jean Claire Palmour | Massage Therapist | 404 South Fifth Street, Jj & Company Salon & Spa, Easley, SC 29640 | 2008-04-22 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1942419171 | William Kent Hammond | Dentist | 298 Enterprise Dr, Easley, SC 29640 | 2007-05-22 |
| Find all providers in zip 29640 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770787426 | Myra Aurelia Phipps | Family Medicine | 303 Dacusville Hwy, Easley, SC 29640-1510 | 2007-06-14 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1265645352 | Palmetto Health | Family Medicine | 104 Fleetwood Drive, Easley, SC 29640 | 2007-05-07 |
| 1821018391 | Anne-marie Catherine Leventis | Family Medicine | 202 Buckingham Rd, Easley, SC 29640-1358 | 2006-07-20 |
| 1609895523 | Marian Barton Clinch | Family Medicine | 300 Fleetwood Drive, Easley, SC 29640 | 2006-07-19 |
| 1235174848 | Palmetto Health | Family Medicine | 201 W A Ave, Easley, SC 29640-2051 | 2006-06-18 |
| 1790737369 | Palmetto Health | Family Medicine | 106 John St, Suite B, Easley, SC 29640-1415 | 2006-05-16 |
| 1811948896 | Palmetto Health | Family Medicine | 104 Fleetwood Dr, Easley, SC 29640-2020 | 2006-05-13 |
| 1033173778 | Patrick G Lollis | Family Medicine | 700 Brushy Creek Rd, Easley, SC 29642-2200 | 2006-04-12 |
| 1558364109 | Ben William Wilson Jr. | Family Medicine | 10701 Anderson Rd, Easley, SC 29642-9309 | 2005-05-27 |
| Find all providers in EASLEY | ||||
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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.