OrganizationActive
Prisma Health-Upstate
NPI 1336695436 · Developmental Disabilities Clinic/Center · Greenville, SC
Provider details
- NPI number
- 1336695436
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities 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
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
29 N Academy St
Greenville, SC 29601-2629
Phone: (864) 331-1350
Street-level locationGet directions
Mailing address
300 E Mcbee Ave Fl 4
Greenville, SC 29601-2842
Other names (DBA / former)
- Doing business as
- Prisma Health Kidnetics-Medicaid
Registry dates
- Enumerated
- 2016-08-29
- Last updated
- 2021-02-04
- Certified
- 2021-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.