Prisma Health-Upstate
NPI 1205414828 · Rural Health Clinic/Center · Fountain Inn, SC
Enrolled with Medicare as Part a Provider - Rural Health Clinic · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Prisma Health-Upstate is a Rural Health Clinic/Center organization in Fountain Inn, SC (NPI 1205414828).
Provider details
- NPI number
- 1205414828
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Polly Miller, Vp, Payor Strategies & Alignment(864) 522-2286
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Prisma Health Primary Care Fountain Inn
- Doing business as
- Prisma Health Primary Care Fountain Inn
Registry dates
- Enumerated
- 2021-04-02
- Last updated
- 2022-04-22
- Certified
- 2022-04-22
Frequently asked questions
- What is Prisma Health-Upstate's NPI number?
- Prisma Health-Upstate's National Provider Identifier (NPI) is 1205414828, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Prisma Health-Upstate?
- Prisma Health-Upstate is classified in the NPPES registry as Rural Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Prisma Health-Upstate located?
- Prisma Health-Upstate's practice location on file with NPPES is 200 N. Nelson Drive, Fountain Inn, SC 29644.
- What is Prisma Health-Upstate's phone number?
- The practice phone number listed in the NPPES registry for Prisma Health-Upstate is (864) 522-6270.
- Does Prisma Health-Upstate accept Medicare?
- Prisma Health-Upstate is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Prisma Health-Upstate?
- The authorized official listed on Prisma Health-Upstate's NPPES record is Polly Miller, Vp, Payor Strategies & Alignment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Prisma Health-Upstate's NPI active?
- Yes — Prisma Health-Upstate's NPI (1205414828) is active in the NPPES registry as of the last update on 2022-04-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.