NPIMap

Individual provider Active NPI

Vladimer Kitiashvili, MD

  • Hospitalist Physician
  • Greenville, SC
National Provider Identifier
1639690662
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
88927 Issued in SC
Practice address
701 Grove Rd FL 5
Greenville, SC 29605-4210
Phone
(864) 455-4411
Fax
(864) 455-4480
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S6661 TX
Hospitalist Physician 208M00000X 88927 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 5
Greenville, SC 29605-4210

Mailing address

300 E McBee Ave # SL4
Greenville, SC 29601-2842

Other practice location 1

34 Maple street
Norwalk, CT 06856
Phone (203) 852-2025

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200824001171 TX Practitioner - Internal Medicine 8022376201 Reassigns benefits to 2 organizations
I20230202000072 SC Practitioner - HospitalistPractitioner - Internal Medicine 8022376201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

701 Grove Rd
Suite 5
Greenville, SC 29605-4210
Phone (864) 455-4411

Hospital & facility affiliations

  • Interim Healthcare of the Upstate Home health agency, Greenville, SC, CCN 427015
  • Prisma Health Home Health-Upstate Home health agency, Greenville, SC, CCN 427029
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88927SCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 20, 2023 Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Feb 20, 2023 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Prisma Health-Upstate Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
#4
Greenville, SC 29601

701 Grove Rd
#5
Greenville, SC 29605
Phone (864) 455-4411

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1717 Highway 59 Loop N
Livingston, TX 77352
Phone (936) 329-8500

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1639690662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE # SL4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 5",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-4411",
            "fax_number": "864-455-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Maple street",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "06856",
            "country_code": "US",
            "telephone_number": "203-852-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITIASHVILI",
        "first_name": "VLADIMER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S6661",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "88927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.