Provider Type Icon

PRISMA HEALTH UNIVERSITY MEDICAL GROUP NPI 1578890273


NPI Information

NPI: 1578890273
Provider Name: PRISMA HEALTH UNIVERSITY MEDICAL GROUP

Doing Business As: PH DEVELOPMENTAL PEDIATRICS

Classification: Pediatrics - 2080P0006X
Entity Type: Organization

Specialization: Developmental - Behavioral Pediatrics

Address:
200 PATEWOOD DR
SUITE A200
GREENVILLE, SC
ZIP 29615
Phone: (864) 454-5115
Get Directions

PRISMA HEALTH UNIVERSITY MEDICAL GROUP is a developmental - behavioral pediatrics pediatrics in Greenville, SC. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. PRISMA HEALTH UNIVERSITY MEDICAL GROUP NPI is 1578890273. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ph Developmental Pediatrics.

The provider's business location address is:

200 PATEWOOD DR
SUITE A200
GREENVILLE, SC
ZIP 29615-593
Phone: (864) 454-5115

The provider's authorized official is Kristi Ann Lawrence .
The authorized official title is Director Provider Enrollment & Cvo and has the following contact phone number (864) 522-8611.

The enumeration date for this NPI number is 11/17/2009 and was last updated on 2/23/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0006XPediatricsDevelopmental - Behavioral PediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DRC010MEDICAIDSOUTH CAROLINA
2DEC300MEDICAIDSOUTH CAROLINA
320032744OTHERSOUTH CAROLINASELECT HEALTH ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.