Prisma Health-Upstate
Organization Active NPI General Acute Care Hospital · Greenville, SC
NPI 1508312604 · NPPES record last updated Jan 30, 2023
Key facts
- NPI
- 1508312604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- ASF-0132 (SC)
- Legal business name
- PRISMA HEALTH-UPSTATE
- Practice address
- 9 Doctors Dr
Greenville, SC 29605-4266 - Phone
- (864) 455-8400
- NPI assigned
- Aug 29, 2016
- Organization subpart
- No
Authorized official
- Name
- Polly H. Miller
- Title
- SVP Finance, Enterprise Contracting
- Phone
- (864) 522-2286
Other NPIs on the same Medicare enrollment 52
Related certifications (CCN) 3
Practitioners 3
-
Brandon Dawson, M.D.
-
Jason L Mortenson, CRNA
-
James W Richardson, CRNA
Affiliated clinicians 2,058
-
Wesley Matthew Abadie, M.D.
-
Fiby Kamel Abd El Malek, M.D.
-
John Robert Absher, M.D.
-
John David Adams Jr., M.D.
-
John F Adams, NP
-
Kaylee Hannah Adams, PA-C
-
Murat Akyildiz, MD
-
Stormie Albrecht, NP
-
Jay Alden, DO
-
Judson Alderman, M.D.
-
Louise Anne Alexander, M.D.
-
Nathan Scott Alexander, M.D.
-
Virginia Mary Alexander, M.D.
-
Zahid Ali, MD
Medicare Care Compare: Hospital
- Listed as
- Prisma Health Greenville Memorial Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- No
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D0674558 | Prisma Health - Upstate Dba Prisma Health | Accreditation | May 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC
Hospital certification: CCN 420078
- Legal name
- PRISMA HEALTH-UPSTATE
- Doing business as
- PRISMA HEALTH PEDIATRICS VERDAE
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Nov 6, 1972
- Last certification
- Jun 12, 2015
- Beds
- 845
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Oct 1, 2016 (1 total)
- Organization structure
- Other · Non-profit
- Incorporated
- Apr 1, 2019 in SC
- Enrollment address
- 701 Grove Rd
Greenville, SC 29605-4210 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Kristi a Lawrence |
Corporate Director |
Apr 5, 2020 | 100% |
| W-2 Managing Employee |
Apr 5, 2020 | 100% | |
| Polly H Miller |
Corporate Officer |
Mar 20, 2020 | 100% |
| W-2 Managing Employee |
Mar 20, 2020 | 100% | |
| Operational/Managerial Control |
Mar 20, 2020 | 100% | |
| Prisma Health-Upstate |
5% Or Greater Direct Ownership Interest | Oct 1, 2016 | 100% |
| Operational/Managerial Control | Oct 1, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161118000626 | SC | Part a Provider - Hospital | 5698063162 |
38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20161222000767 | SC | Part B Supplier - Clinic/Group Practice | 5698063162 |
Receives reassigned benefits from 438 practitioners 41 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Greenville, SC; Greer, SC; Seneca, SC; Simpsonville, SC; Spartanburg, SC; Travelers Rest, SC; Clinton, SC; Easley, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | ASF-0132 | SC | Yes |
Addresses
Primary practice location
9 Doctors Dr
Greenville, SC 29605-4266
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 455-7000
Other names
- Prisma Health OP Surgery Cross Creek
Other providers in Greenville, SC
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
All providers in Greenville, SC · General Acute Care Hospital in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.