NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting Office

Doing business as Patrick B Harris Psychiatric Hospital

  • Psychiatric Hospital
  • Anderson, SC
National Provider Identifier
1245255389
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
HTL503 Issued in SC
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
Patrick B Harris Psychiatric Hospital
Practice address
130 Highway 252
Anderson, SC 29621-5054
Phone
(803) 231-2673
NPI assigned
Jul 12, 2006
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CAROLINA DEPT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Versie Bellamy
Title
Deputy Director
Phone
(803) 935-5761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X HTL503 SC Primary

Addresses

Primary practice location

130 Highway 252
Anderson, SC 29621-5054

Mailing address

PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
A00503MedicaidSC

Other names 1

  • Patrick B Harris Psychiatric Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200214000262 SC Part A Provider - Hospital 9032021175 Practice locations: Anderson, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245255389. Details of each certification follow.

Hospital certification: CCN 424011

Legal name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
PATRICK B HARRIS PSYCHIATRIC HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 2, 1986
Last certification
Aug 13, 2021
Beds
200
Ownership / control type
State
Organization structure
CorporationNon-profit
Enrollment address
130 Highway 252
Anderson, SC 29621-5054
Hospital Psychiatric Unit
Hospital subgroups
Other

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Patrick B Harris Psychiatric HospitalCCN 424011 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Part of
Pee Dee Mental Health C

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

130 Highway 252
Anderson, SC 29621
Phone (864) 231-2600

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Robert L Bank Individual Corporate Director Apr 30, 2016
Allen McEniry Individual 5% Or Greater Indirect Ownership Interest Jul 17, 2016
Corporate Director Jul 17, 2016
Versie J Bellamy Individual Corporate Director Sep 1, 2016
W-2 Managing EmployeeDirector Reim Sep 1, 2016
Tracy Turner Individual W-2 Managing Employee May 1, 2016
South Carolina Dept of Mental Health Accounting Office Organization, Anderson, SC Corporation 5% Or Greater Direct Ownership Interest Sep 7, 2016
Operational/Managerial Control Dec 29, 1986

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Carolina Dept of Mental Health Accounting OfficeColumbia, SC, CCN 424005 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1978
CM Tucker Jr Nursing CareColumbia, SC, CCN 425074 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1970
Jan 1, 1970
C.M. Tucker Jr Nursing Care Center-Roddey PavillionColumbia, SC, CCN 425360 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jan 1, 2006

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1245255389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020485",
            "telephone_number": "803-898-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HIGHWAY 252",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215054",
            "telephone_number": "803-231-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "BELLAMY",
        "authorized_official_first_name": "VERSIE",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "803-935-5761"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "SC",
            "license": "HTL503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A00503",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patrick B Harris Psychiatric Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Patrick B Harris Psychiatric Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.