Greenville Health System

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GREENVILLE HEALTH SYSTEM

Doing business as

GHS Clemson-Seneca Ped - Clem

Practice address

208 Frontage Rd Ste 1
Clemson, SC 29631-1671

Phone

(864) 654-6034

Fax

(864) 654-0342

NPI assigned

Feb 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael C Riordan

Title

President/Ceo

Phone

(864) 797-7808

Specialties & licenses 1

Addresses

Other names 1

• GHS Clemson-Seneca Ped - Clem Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Prisma Health-Upstate

  dba Prisma Health Pediatrics-Clemson

  • Rural Health Clinic/Center
  • Clemson, SC
  • NPI 1619423704

  Sold to, 2016-10-01

  CMS change of ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1043602428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6308",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 FRONTAGE RD STE 1",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311671",
            "telephone_number": "864-654-6034",
            "fax_number": "864-654-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "RIORDAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "864-797-7808"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GHS Clemson-Seneca Ped - Clem",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Warren Douglas Gentry, M.D.
• Monica Hayes Gibson, PT
• Jamie Gladfelder, RPH
• Trenton Wesley Goff, PHARMD
• Kenneth A Gosnell, CH
• Ellery Gregory
• William Victor Griffith, MD
• Nicole Elena Grimm, L.P.C.
• Margaret Grisham, LPC/I
• Caroline Guilfoil, RD

• Rural Health Clinic/Center in Clemson, SC
• Providers in Clemson, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.