NPIMap

Organization Active NPI

Upstate Affiliate Organization

Doing business as GHS Cancer Inst-Andrews

  • General Acute Care Hospital
  • Greenville, SC
National Provider Identifier
1548716665
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HTL-0936 Issued in SC
Legal business name
UPSTATE AFFILIATE ORGANIZATION
Doing business as
GHS Cancer Inst-Andrews
Practice address
200 Andrews St
Suite 100
Greenville, SC 29601-3969
Phone
(864) 269-4508
NPI assigned
Aug 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Spence M Taylor, MD
Title
President
Phone
(864) 797-6118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HTL-0936 SC Primary

Addresses

Primary practice location

200 Andrews St
Suite 100
Greenville, SC 29601-3969

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4536

Other names 1

  • GHS Cancer Inst-Andrews Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

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
OtherNon-profit
Incorporated
Apr 1, 2019 in SC
Enrollment address
701 Grove Rd
Greenville, SC 29605-4210
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 52

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

View all 52

Care Compare: Hospital

Medicare Care Compare
Listed as
Prisma Health Greenville Memorial HospitalCCN 420078 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Kristi a Lawrence Individual Corporate DirectorDirector, Provider Enrollment & Cvo Apr 5, 2020 100%
W-2 Managing EmployeeDirector, Provider Enrollment & Cvo Apr 5, 2020 100%
Polly H Miller Individual Corporate OfficerSVP Finance, Enterprise Contracting Mar 20, 2020 100%
W-2 Managing EmployeeSVP Finance, Enterprise Contracting Mar 20, 2020 100%
Operational/Managerial ControlSVP Finance, Enterprise Contracting Mar 20, 2020 100%
Prisma Health-Upstate Organization, Greenville, SC Created for acquisition 5% Or Greater Direct Ownership Interest Oct 1, 2016 100%
Operational/Managerial Control Oct 1, 2016 100%

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2,058

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

View all 2,058

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1548716665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ANDREWS ST",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013969",
            "telephone_number": "864-269-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE AFFILIATE ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SPENCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-797-6118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL-0936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GHS Cancer Inst-Andrews",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.