NPIMap

Organization Active NPI

Prisma Health-Upstate

Doing business as Prisma Health Transplant Center

  • General Acute Care Hospital
  • Greenville, SC
National Provider Identifier
1720747496
Registry record updated Dec 8, 2022
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 Transplant Center
Practice address
890 W Faris Rd Ste 510
Greenville, SC 29605-4286
Phone
(864) 455-1770
Fax
(864) 455-1775
NPI assigned
Dec 10, 2021
Last updated
Dec 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Authorized official

Name
Polly H. Miller
Title
SVP Finance, Enterprise Contracting
Phone
(864) 522-2286

Specialties & licenses 1

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

Addresses

Primary practice location

890 W Faris Rd Ste 510
Greenville, SC 29605-4286

Mailing address

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

Other names 1

  • Prisma Health Transplant Center Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720747496. Details of each certification follow.

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 38

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

View all 38

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

Member of 1

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

  • Prisma Health-Upstate

    dba Prisma Health Roger C Peace-TBI

    • Comprehensive Outpatient Rehabilitation Facility (CORF)
    • Greenville, SC
    • NPI 1861947756

    Member Of

    NPD member

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

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": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1720747496",
    "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": "890 W FARIS RD STE 510",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054286",
            "telephone_number": "864-455-1770",
            "fax_number": "864-455-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH-UPSTATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SVP FINANCE, ENTERPRISE CONTRACTING",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Transplant Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prisma Health Transplant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.