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PRISMA HEALTH ADVANCED FAMILY MEDICINE
NPI 1134512395
Clinic/Center - Rural Health in Clinton, SC

Active since March 12, 2015CLIA Certified · 3 labs
210 S BROAD ST, CLINTON, SC 29325(864) 833-0973(864) 833-9571 Get Directions Write a Review

NPPES record last updated: February 4, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 4, 2021, Apr 14, 2020, May 15, 2019 and 2 more (5 updates tracked since 2016).

About Prisma Health Advanced Family Medicine NPPES

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

PRISMA HEALTH ADVANCED FAMILY MEDICINE (NPI 1134512395) is a healthcare organization registered as a rural health in Clinton, South Carolina and active in the NPI registry since March 2015. The organization holds 3 active CLIA laboratory certificates and lists Polly H. Miller, Vp Payor Strategies & Alignment, as its authorized official.

NPPES Registry Identity

NPI1134512395
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePRISMA HEALTH-UPSTATE
Location Address210 S BROAD STClinton, SC 29325-2505
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 455-7000
Phone(864) 833-0973
Fax(864) 833-9571
Organization SubpartNo
Authorized OfficialPolly H. MillerVp Payor Strategies & Alignment · (864) 522-2286
Enumeration DateMarch 12, 2015
Last NPPES UpdateFebruary 4, 20215 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2021
✔ NPI 1134512395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
210 S BROAD ST, Clinton, SC 29325
Open in Google Maps ↗

Other Names 1

Doing Business AsPrisma Health Advanced Family Medicine

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

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 42D2119172

Prisma Health Advanced Family Medicine · Clinton, SC
Active · expires Sep 20, 2026
CLIA Number42D2119172
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2024
Certificate Expiration DateSeptember 20, 2026
Laboratory DirectorGeoffrey Carlson
Laboratory Phone(864) 833-0973
Laboratory LocationPrisma Health Advanced Family Medicine210 S Broad Street, Clinton, SC 29325
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 42D2062190

Prisma Health Upstate Wound Center · Clinton, SC
Active · expires Jul 10, 2027
CLIA Number42D2062190
Laboratory TypePhysician Office
Certificate Effective DateJuly 11, 2025
Certificate Expiration DateJuly 10, 2027
Laboratory DirectorKayla Staton
Laboratory Phone(864) 833-3557
Laboratory LocationPrisma Health Upstate Wound Center1073 Medical Ridge Road, Clinton, SC 29325
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 42D0250148

Prisma Health - Upstate Dba Prisma Health Laurens County Hospital Laboratory · Clinton, SC
Active · expires Jan 2, 2027
CLIA Number42D0250148
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Dongfang Yu
Laboratory Phone(864) 833-9423
Laboratory LocationPrisma Health - Upstate Dba Prisma Health Laurens County Hospital LaboratoryPO Box 976 Highway 76, Clinton, SC 29325
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 7

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

SARA P MOORE
Nurse Practitioner (Family)
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973
HOLBROOK WYMAN RAYNAL M.D., D.H.A.
Family Medicine
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973
PRISMA HEALTH-UPSTATE
Clinic/Center (Multi-Specialty)
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973
NEAL ROBERT GOODBAR MD
Family Medicine
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-1973
GEOFFREY CARLSON PA
Physician Assistant (Medical)
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973
MS. MEGHAN ELIZABETH WILLIAMS PA-C
Physician Assistant
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973
WENDY W NIX FNP
Nurse Practitioner (Family)
210 S BROAD ST
CLINTON, SC 29325
Laurens County (864) 833-0973

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 1134512395. It was assigned to this organization in the NPPES registry on March 12, 2015. The provider is doing business as Prisma Health Advanced Family Medicine.

Where is Prisma Health-Upstate located?

Prisma Health-Upstate is located at 210 S Broad St, Clinton, SC 29325. The listed phone number is (864) 833-0973.

What is Prisma Health-Upstate's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Prisma Health-Upstate hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Prisma Health-Upstate accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and InStil Health list Prisma Health-Upstate as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prisma Health-Upstate was last updated on February 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.