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UPSTATE CAROLINA MEDICAL LLC
NPI 1457002123
Nurse Practitioner in Clemson, SC

Active since January 14, 2022
144 THOMAS GREEN BLVD STE 232, CLEMSON, SC 29631(864) 722-5203(864) 722-5203 Get Directions Write a Review

NPPES record last updated: June 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Upstate Carolina Medical Llc NPPES

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

UPSTATE CAROLINA MEDICAL LLC (NPI 1457002123) is a healthcare organization registered as a nurse practitioner in Clemson, South Carolina and active in the NPI registry since January 2022. The organization maintains a secondary practice location in Seneca and lists Jessica Vassallo, Owner/ Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1457002123
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameUPSTATE CAROLINA MEDICAL LLC
Location Address144 THOMAS GREEN BLVD STE 232Clemson, SC 29631-2291
Mailing Address144 Thomas Green Blvd Ste 232Clemson, SC 29631-2291 · (864) 722-5203 · Fax (864) 722-5203
Phone(864) 722-5203
Fax(864) 722-5203
Organization SubpartNo
Authorized OfficialJessica VassalloOwner/ Nurse Practitioner · (864) 903-9604
Enumeration DateJanuary 14, 2022
Last NPPES UpdateJune 1, 2022
NPPES CertifiedJune 1, 2022
✔ NPI 1457002123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
144 THOMAS GREEN BLVD STE 232, Clemson, SC 29631
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Secondary Practice Location 1

Location 1205 Central Park Ln Ste ASeneca, SC 29678-1156 · Phone (864) 903-9604

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Upstate Carolina Medical LLC's NPI number?

The NPI number for Upstate Carolina Medical LLC is 1457002123. It was assigned to this organization in the NPPES registry on January 14, 2022.

Where is Upstate Carolina Medical LLC located?

Upstate Carolina Medical LLC is located at 144 Thomas Green Blvd Ste 232, Clemson, SC 29631. The listed phone number is (864) 722-5203.

What is Upstate Carolina Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Upstate Carolina Medical LLC was last updated on June 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.