NPIMap

Organization Active NPI

Pruitthealth Hospice, Inc.

Doing business as PruittHealth Hospice - Anderson

  • Community Based Hospice Care Agency
  • Anderson, SC
National Provider Identifier
1174878342
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRUITTHEALTH HOSPICE, INC.
Doing business as
PruittHealth Hospice - Anderson
Practice address
1510 N Fant St
Anderson, SC 29621-4708
Phone
(864) 226-1219
Fax
(864) 226-8730
NPI assigned
Jul 13, 2012
Last updated
Apr 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PRUITTHEALTH HOSPICE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Neil L Pruitt Jr.
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1510 N Fant St
Anderson, SC 29621-4708

Mailing address

1626 Jeurgens CT
Legal Dept
Norcross, GA 30093-2219
Phone (770) 279-6200

Other names 1

  • PruittHealth Hospice - Anderson Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060103000094 SC Part A Provider - Hospice 2264344217 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC; Anderson, SC; Greenville, SC
O20221214002911 SC Part B Supplier - Clinic/Group Practice 2264344217 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
Practice locations: Okatie, SC; Ladson, SC; Greenville, SC; Columbia, SC; Anderson, SC; Aiken, SC; Florence, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174878342. Details of each certification follow.

Hospice certification: CCN 421565

Legal name
PRUITTHEALTH HOSPICE INC
Doing business as
PRUITTHEALTH HOSPICE-COLUMBIA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 11, 2006
Last certification
Feb 25, 2022
Ownership / control type
Proprietary - Individual
Organization structure
CorporationProprietary
Incorporated
Oct 14, 1993 in GA
Enrollment address
240 Stoneridge Dr
Ste 302
Columbia, SC 29210-8013

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Pruitthealth Hospice- ColumbiaCCN 421565 · All quality measures
Ownership
For-Profit
Certified
Apr 11, 2006
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2048684Pruitthealth Hospice Anderson, Inc1510 North Fant Street, Anderson, SC 29621Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory
Tax ID family
Pruitthealth Hospice Inc26 organizations share this tax ID, including this one
Part of
Pruitthealth Hospice Inc

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lance Danko Individual W-2 Managing Employee Oct 27, 2017 100%
Hannah Burris Individual W-2 Managing Employee100 Oct 18, 2021
United Health Services Inc Organization, Toccoa, GA Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest May 15, 2003 100%
Angela D. McCarn Individual W-2 Managing Employee Jul 1, 2020
Pruitthealth Inc Organization, Norcross, GA 5% Or Greater Direct Ownership Interest Jan 1, 2022
Operational/Managerial Control Jan 7, 2008
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 28.84%
Neil Little Pruitt Individual Corporate Officer Apr 12, 1999
Corporate Director Jan 3, 2006
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 35.19%
Teresa Sexton Individual W-2 Managing Employee Sep 19, 2019 100%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Thomas R Beddingfield Individual Corporate DirectorDirector Sep 17, 2013
United Health Services of Georgia, Inc. Organization, Toccoa, GA 5% Or Greater Direct Ownership Interest Oct 31, 2003
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.32%

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

Affiliated clinicians 12

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1174878342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214708",
            "telephone_number": "864-226-1219",
            "fax_number": "864-226-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH HOSPICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRUITTHEALTH HOSPICE, INC.",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Hospice - Anderson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Hospice - Anderson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.