PRISMA HEALTH UNIVERSITY MEDICAL GROUP (NPI# 1568799955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568799955 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH UNIVERSITY MEDICAL GROUP |
| Other Organization Name | UNIVERSITY MEDICAL GROUP/GREENVILLE RADIOLOGY |
| Practice Address |
1210 W Faris Rd Greenville SC 29605-4444 |
| Mailing Address |
300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 |
| Practice Telephone | 8642954410 |
| Practice Fax Number | 8642955694 |
| Mailing Telephone | 8645228617 |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | POLLY H MILLER (VP OF PAYOR STRATEGIES & ALIGNMENTS) |
| Authorized Official Telephone | 8645222286 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP5312 | 05 |
| Other Name | Type Code |
|---|---|
| University Medical Group/Greenville 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 |
| 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 |
1210 W FARIS RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508865510 | Blake Christopher Poleynard | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2005-07-20 |
| 1821584228 | Gregory Randal Bryant | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2018-07-09 |
| 1235685330 | Prisma Health-upstate | Clinic/Center | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2016-08-29 |
| 1962816058 | Michael Knipfing | Family Medicine | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2014-06-17 |
| 1356755573 | Samuel Douglas Volin | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2014-06-16 |
| 1891105896 | Sanjay Hasmukhlal Mahatma | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2014-04-30 |
| 1750729273 | Gregory Scott Matthews | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2013-06-06 |
| 1790028868 | Richard Christopher Leach | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2013-03-27 |
| 1689920464 | Pavani Thotakura Shah | Internal Medicine | 1210 W Faris Rd, Greenville, SC 29605 | 2012-07-30 |
| 1750642096 | Todd Michael Danziger | Radiology | 1210 W Faris Rd, Greenville, SC 29605 | 2012-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| 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 |
|---|---|---|---|---|
| 1417423088 | Bon Secours Diagnostic Imaging | Radiology | 1 Marcus Dr Ste 100, Greenville, SC 29615-4818 | 2018-10-22 |
| 1700352374 | Bon Secours Diagnostic Imaging | Radiology | 2 Innovation Dr Ste 350, Greenville, SC 29607-5269 | 2018-10-22 |
| 1710292313 | Eastern Radiologist Inc | Radiology | 2090a W Arlington Blvd, Greenville, NC 27834-5727 | 2010-08-09 |
| 1790002822 | Gd Radiology Pa | Radiology | 4215 Joe Ramsy Blvd, Greenville, TX 75401-7852 | 2010-04-29 |
| 1497998934 | Comanche County Hospital Authority Southwest Radiology | Radiology | 101 Babbs Holw, Greenville, SC 29607-3745 | 2009-04-14 |
| 1235324476 | Mchenry Peters Jr. | Radiology | 110 Windward Rd, Greenville, DE 19807-2436 | 2007-09-11 |
| 1679775001 | Molecular Imaging Assoc Pllc | Radiology | 136 Fioranelli Dr, Greenville, MS 38701-7313 | 2007-06-05 |
| 1730258831 | Robert P Oliver | Radiology | 5 Orchard Pl, Greenville, MS 38701-8079 | 2006-11-06 |
| 1043321920 | Donald S Prior | Radiology | 1654 S Colorado St, Greenville, MS 38703-7216 | 2006-08-31 |
| 1295759223 | Charles E Parke | Radiology | 105 Holbrook Trail, Greenville, SC 29605-3164 | 2006-07-26 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.