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PRISMA HEALTH PEDIATRICS-CLEMSON
NPI 1013698687
Clinic/Center - Multi-Specialty in Clemson, SC

Active since July 27, 2023CLIA 42D0252845 · Waiver
450 OLD GREENVILLE HWY, CLEMSON, SC 29631(864) 653-8964(864) 653-8963 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2023, Jul 27, 2023 (2 updates tracked since 2023).

About Prisma Health Pediatrics-clemson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRISMA HEALTH PEDIATRICS-CLEMSON (NPI 1013698687) is a healthcare organization registered as a multi-specialty in Clemson, South Carolina and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through October 5, 2026 and lists Polly H Miller, Svp Finance Enterprise Contracting, as its authorized official.

NPPES Registry Identity

NPI1013698687
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePRISMA HEALTH-UPSTATE
Location Address450 OLD GREENVILLE HWYClemson, SC 29631-1670
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-2286
Phone(864) 653-8964
Fax(864) 653-8963
Organization SubpartNo
Authorized OfficialPolly H MillerSvp Finance Enterprise Contracting · (864) 522-2286
Enumeration DateJuly 27, 2023
Last NPPES UpdateOctober 12, 20232 updates tracked since enumeration
NPPES CertifiedOctober 12, 2023
✔ NPI 1013698687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
450 OLD GREENVILLE HWY, Clemson, SC 29631
Open in Google Maps ↗

Other Names 1

Doing Business AsPrisma Health Pediatrics-clemson

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D0252845

Prisma Health Pediatrics- Clemson · Clemson, SC
Active · expires Oct 5, 2026
CLIA Number42D0252845
Laboratory TypePhysician Office
Certificate Effective DateOctober 6, 2024
Certificate Expiration DateOctober 5, 2026
Laboratory DirectorLorraine A. Bruce
Laboratory Phone(864) 653-8964
Laboratory LocationPrisma Health Pediatrics- Clemson450 Old Greenville Highway, Clemson, SC 29631
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTOINETTE MARIE BANNISTER M.D.
Pediatrics
450 OLD GREENVILLE HWY
CLEMSON, SC 29631
Pickens County (864) 653-8964
MARION A WILLS M.D.
Pediatrics
450 OLD GREENVILLE HWY
CLEMSON, SC 29631
Pickens County (864) 653-8964
PRISMA HEALTH-UPSTATE
Clinic/Center (Rural Health)
450 OLD GREENVILLE HWY
CLEMSON, SC 29631
Pickens County (864) 653-8964
BETH LYNN DICKERSON NP
Nurse Practitioner (Pediatrics)
450 OLD GREENVILLE HWY
CLEMSON, SC 29631
Pickens County (864) 653-8964

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prisma Health-Upstate's NPI number?

The NPI number for Prisma Health-Upstate is 1013698687. It was assigned to this organization in the NPPES registry on July 27, 2023. The provider is doing business as Prisma Health Pediatrics-Clemson.

Where is Prisma Health-Upstate located?

Prisma Health-Upstate is located at 450 Old Greenville Hwy, Clemson, SC 29631. The listed phone number is (864) 653-8964.

What is Prisma Health-Upstate's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Prisma Health-Upstate hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D0252845) is associated with this NPI, valid through October 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prisma Health-Upstate was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.