PRISMA HEALTH PEDIATRICS-CLEMSON – NPI #1013698687
Clinic/Center

PRISMA HEALTH PEDIATRICS-CLEMSON is an AHC clinic located in CLEMSON, SC. NPPES has assigned the NPI number 1013698687 to PRISMA HEALTH PEDIATRICS-CLEMSON on July 27, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PRISMA HEALTH PEDIATRICS-CLEMSON” is a dba name, the actual legal business name for this organization is PRISMA HEALTH-UPSTATE. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was previously updated about 3 years ago on Oct 12, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRISMA HEALTH PEDIATRICS-CLEMSON below.

NPI Profile for
PRISMA HEALTH-UPSTATE

NPI Number
1013698687
Enumeration Date

(about 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRISMA HEALTH-UPSTATE
Doing Business As (dba): PRISMA HEALTH PEDIATRICS-CLEMSON
Primary location
450 OLD GREENVILLE HWY
CLEMSON, SC 29631-1670
Phone: (864) 653-8964 Fax: (864) 653-8963
Mailing address
300 E MCBEE AVE FL 4
GREENVILLE, SC 29601-2842
Phone: (864) 522-2286 Fax:
Organization Subpart
No
Authorized Official
POLLY MILLER
SVP FINANCE ENTERPRISE CONTRACTING
Phone: (864) 522-2286
Updated
Certification Date
Oct 12, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.