NPIMap

Organization Active NPI

Prisma Health-Upstate

Doing business as Prisma Health Baptist Easley Hospital

  • General Acute Care Hospital
  • Easley, SC
National Provider Identifier
1639656713
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PRISMA HEALTH-UPSTATE
Doing business as
Prisma Health Baptist Easley Hospital
Practice address
200 Fleetwood Dr
Easley, SC 29640-2022
Phone
(864) 442-7200
NPI assigned
Jul 23, 2018
Last updated
Feb 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Polly H. Miller
Title
VP Payor Strategies & Alignment
Phone
(864) 522-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

200 Fleetwood Dr
Easley, SC 29640-2022

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 455-7000

Other names 1

  • Prisma Health Baptist Easley Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20181126001379 SC Part A Provider - Hospital 5698063162 4 other NPIs on this enrollment
Practice locations: Greenville, SC; Easley, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639656713. Details of each certification follow.

Hospital certification: CCN 420015

Legal name
PRISMA HEALTH-UPSTATE
Doing business as
PRISMA HEALTH BAPTIST EASLEY HOSPITAL O/P THERAPY SERVICES
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 13, 2021
Beds
109
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 2018 (4 total)
Organization structure
OtherNon-profit
Incorporated
Apr 1, 2019 in SC
Enrollment address
200 Fleetwood Dr
Easley, SC 29640-2022
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 45

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

View all 45

Care Compare: Hospital

Medicare Care Compare
Listed as
Prisma Health Baptist Easley HospitalCCN 420015 · 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
Yes

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 Employee Apr 5, 2020
Polly H Miller Individual Corporate OfficerSVP Finance, Enterprise Contracting Mar 20, 2020 100%
W-2 Managing Employee Mar 20, 2020
Operational/Managerial Control Mar 20, 2020
Prisma Health-Upstate Organization, Greenville, SC 5% Or Greater Direct Ownership Interest Oct 1, 2018 100%
Operational/Managerial Control Oct 1, 2018 100%

All facility ownership & control disclosures 26

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

FacilityTypeRoleSince
Prisma Health Hillcrest HospitalSimpsonville, SC, CCN 420037 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Greer Memorial HospitalGreer, SC, CCN 420033 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Marshall I PickensGreenville, SC, CCN 42S078 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Roger C Peace RehabilitationGreenville, SC, CCN 42T078 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Pediatrics VerdaeGreenville, SC, CCN 420078 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Oconee Memorial HospitalSeneca, SC, CCN 420009 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Laurens County HospitalClinton, SC, CCN 420038 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Oct 1, 2016
Oct 1, 2016
Prisma Health Patewood HospitalGreenville, SC, CCN 420102 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health North Greenville LtachTravelers Rest, SC, CCN 422008 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Home Health--UpstateGreenville, SC, CCN 427029 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Hospice of the FoothillsSeneca, SC, CCN 421508 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2019
Apr 1, 2019
PH Pediatrics-ClemsonClemson, SC, CCN 423455 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Laurens Family Med-MainLaurens, SC, CCN 423452 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2019
Apr 1, 2019
Prisma Health Laurens Family Med-Gray CTGray Court, SC, CCN 423454 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
PH Pediatrics-SenecaSeneca, SC, CCN 423456 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
Prisma Health Advanced Family MedicineClinton, SC, CCN 423458 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2016
Oct 1, 2016
PH Family Medicine-WalhallaWalhalla, SC, CCN 423475 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Seneca Medical AssociatesSeneca, SC, CCN 423474 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Mountain Lakes Family MedicineSeneca, SC, CCN 423476 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Family & Internal Medicine-SenecaSeneca, SC, CCN 423477 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Pediatrics-PowdersvilleGreenville, SC, CCN 423491 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Blue Ridge Women's CenterSeneca, SC, CCN 423490 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Primary Care Fountain InnFountain Inn, SC, CCN 423494 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Premier Women's CareGreenville, SC, CCN 423498 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Primary Care North GreenvilleTravelers Rest, SC, CCN 423495 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Family Medicine-PowdersvilleGreenville, SC, CCN 428501 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019

Facilities with the same owner 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 54

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 54

Affiliated clinicians 584

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

View all 584

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1639656713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-455-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FLEETWOOD DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402022",
            "telephone_number": "864-442-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH-UPSTATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "VP PAYOR STRATEGIES & ALIGNMENT",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Baptist Easley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.