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PRISMA HEALTH PEDIATRICS-POWDERSVILLE
NPI 1376223180
Clinic/Center - Multi-Specialty in Greenville, SC

Active since July 18, 2023CLIA 42D1105535 · Waiver
207 THREE BRIDGES RD, GREENVILLE, SC 29611(864) 220-1110(864) 220-1104 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 10, 2023, Jul 18, 2023 (2 updates tracked since 2023).

About Prisma Health Pediatrics-powdersville NPPES

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

PRISMA HEALTH PEDIATRICS-POWDERSVILLE (NPI 1376223180) is a healthcare organization registered as a multi-specialty in Greenville, South Carolina and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through September 16, 2026 and lists Polly H. Miller, Svp Finance, Enterprise Contracting, as its authorized official.

NPPES Registry Identity

NPI1376223180
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePRISMA HEALTH-UPSTATE
Location Address207 THREE BRIDGES RDGreenville, SC 29611-7549
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-8613
Phone(864) 220-1110
Fax(864) 220-1104
Organization SubpartNo
Authorized OfficialPolly H. MillerSvp Finance, Enterprise Contracting · (864) 522-2286
Enumeration DateJuly 18, 2023
Last NPPES UpdateOctober 10, 20232 updates tracked since enumeration
NPPES CertifiedOctober 10, 2023
✔ NPI 1376223180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
207 THREE BRIDGES RD, Greenville, SC 29611
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Other Names 1

Doing Business AsPrisma Health Pediatrics-powdersville

CLIA Laboratory Certificates CMS CLIA 7

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 42D1105535

Prisma Health Pediatrics Powdersville · Greenville, SC
Active · expires Sep 16, 2026
CLIA Number42D1105535
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2024
Certificate Expiration DateSeptember 16, 2026
Laboratory DirectorDr. Ashley T. Flesher
Laboratory Phone(864) 220-1110
Laboratory LocationPrisma Health Pediatrics Powdersville207 Three Bridges Rd, Greenville, SC 29611
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 42D0252444

Prisma Health Pediatrics- Pleasantburg · Greenville, SC
Active · expires Jun 23, 2028
CLIA Number42D0252444
Laboratory TypePhysician Office
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorMary A. Shepard
Laboratory Phone(864) 271-1450
Laboratory LocationPrisma Health Pediatrics- Pleasantburg890 S Pleasantburg Drive, Greenville, SC 29607
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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D1075601

Prisma Health Pediatric Urology · Greenville, SC
Active · expires Apr 18, 2028
CLIA Number42D1075601
Laboratory TypePhysician Office
Certificate Effective DateApril 19, 2026
Certificate Expiration DateApril 18, 2028
Laboratory DirectorScott W. Walters
Laboratory Phone(864) 454-5105
Laboratory LocationPrisma Health Pediatric Urology200 Patewood Dr, Building A, Ste A115, Greenville, SC 29615
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 42D2288908

Prisma Health - Pediatrics Verdae · Greenville, SC
Active · expires Aug 31, 2027
CLIA Number42D2288908
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorGeorge C. Haddad
Laboratory Phone(864) 522-6000
Laboratory LocationPrisma Health - Pediatrics Verdae905 Verdae Blvd, Suite 102, Greenville, SC 29607
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 42D2083236

Prisma Health Pediatrics- Traveler's Rest · Greenville, SC
Active · expires May 19, 2027
CLIA Number42D2083236
Laboratory TypePhysician Office
Certificate Effective DateMay 20, 2025
Certificate Expiration DateMay 19, 2027
Laboratory DirectorMary A. Shepard
Laboratory Phone(864) 522-2600
Laboratory LocationPrisma Health Pediatrics- Traveler's Rest415 Duncan Chapel Road, Greenville, SC 29617
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.

Certificate of Waiver 42D0665917

Prisma Health Pediatrics- Maxwell Pointe · Greenville, SC
Active · expires Apr 1, 2027
CLIA Number42D0665917
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2025
Certificate Expiration DateApril 1, 2027
Laboratory DirectorAndrea Nesbit
Laboratory Phone(864) 522-1340
Laboratory LocationPrisma Health Pediatrics- Maxwell PointeMaxwell Pointe Medical Center 3911 South Highway 14, Greenville, SC 29615
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

ASHLEY TORRENCE FLESHER M.D.
Pediatrics
207 THREE BRIDGES RD
GREENVILLE, SC 29611
Greenville County (864) 269-5567
DR. WILLIAM RANDOLPH WILSON M.D.
Pediatrics
207 THREE BRIDGES RD
GREENVILLE, SC 29611
Greenville County (864) 220-1110
PRISMA HEALTH-UPSTATE
Clinic/Center (Rural Health)
207 THREE BRIDGES RD
GREENVILLE, SC 29611
Greenville County (864) 220-1110
MARY LYN BARNETTE
Physician Assistant
207 THREE BRIDGES RD
GREENVILLE, SC 29611
Greenville County (864) 220-1110
ALLYSON PATRICIA COX DO
Pediatrics
207 THREE BRIDGES RD
GREENVILLE, SC 29611
Greenville County (864) 220-1110

Frequently Asked Questions

What is PRISMA HEALTH-UPSTATE's NPI number?

The NPI number assigned to this healthcare provider is 1376223180, enumerated as an "organization" on July 18, 2023.

Where is the provider located?

The provider is located at 207 THREE BRIDGES RD GREENVILLE, SC 29611 and the phone number is (864) 220-1110.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.