NPIMap

Organization Active NPI

Prisma Health-Midlands

Doing business as Prisma Health Hospice Midlands

  • Community Based Hospice Care Agency
  • Columbia, SC
National Provider Identifier
1740398080
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
056 Issued in SC
Legal business name
PRISMA HEALTH-MIDLANDS
Doing business as
Prisma Health Hospice Midlands
Practice address
1205 Colonial Life Blvd W
Columbia, SC 29210-7671
Phone
(803) 296-3100
NPI assigned
Aug 28, 2006
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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
Community Based Hospice Care Agency 251G00000X 056 SC Primary

Addresses

Primary practice location

1205 Colonial Life Blvd W
Columbia, SC 29210-7671

Mailing address

PO Box 402121
Atlanta, GA 30384-2121
Phone (803) 296-3100

Other identifiers 1

IdentifierTypeStateIssuer
HSP028MedicaidSC

Other names 1

  • Prisma Health Hospice Midlands Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070612000212 SC Part A Provider - Hospice 6800708330 Practice locations: Columbia, SC; Newberry, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740398080. Details of each certification follow.

Hospice certification: CCN 421511

Legal name
PRISMA HEALTH-MIDLANDS
Doing business as
PRISMA HEALTH HOSPICE MIDLANDS
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 9, 1991
Last certification
Feb 28, 2020
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 1997 in SC
Enrollment address
1205 Colonial Life Blvd W
Columbia, SC 29210-7671

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Prisma Health Hospice MidlandsCCN 421511 · All quality measures
Ownership
Non-Profit
Certified
Jan 9, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Health105 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1205 Colonial Life Blvd W
Columbia, SC 29210
Phone (803) 296-3100

Ownership & related parties

All disclosed owners & managing parties 2

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 W-2 Managing Employee Apr 5, 2020 100%
Polly H Miller Individual Corporate OfficerSVP Finance, Enterprise Contracting Apr 5, 2020
W-2 Managing EmployeeSVP Finance, Enterprise Contracting Apr 5, 2020

All facility ownership & control disclosures 11

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

FacilityTypeRoleSince
Prisma Health Baptist HospitalColumbia, SC, CCN 420086 Hospital Operational/Managerial Control (100%)
Other		 Apr 1, 2019
Apr 1, 2019
Prisma Health Richland HospitalColumbia, SC, CCN 420018 Hospital 5% Or Greater Direct Ownership Interest (100%)
Other		 Jan 7, 2013
Jan 7, 2013
Prisma Health Richland SpringsColumbia, SC, CCN 42S018 Hospital Operational/Managerial Control
Other		 Sep 26, 1993
Sep 26, 1993
Prisma Health Baptist ParkridgeColumbia, SC, CCN 420106 Hospital Operational/Managerial Control (100%)
Other		 Jan 14, 2014
Jan 14, 2014
Prisma Health Tuomey HospitalColumbia, SC, CCN 42S086 Hospital Operational/Managerial Control
Other		 Oct 1, 1990
Oct 1, 1990
Prisma Health Tuomey HospitalSumter, SC, CCN 420070 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2025
Prisma Health Home HealthColumbia, SC, CCN 427013 Home health agency Operational/Managerial Control (100%) Jan 1, 2007
Prisma Health Tuomey Home HealthSumter, SC, CCN 427078 Home health agency Other Jan 1, 2016
Prisma Health Tuomey HospiceSumter, SC, CCN 421509 Hospice Operational/Managerial Control
Other		 Jan 1, 2016
Jan 1, 2016
PH Family Medicine WinnsboroWinnsboro, SC, CCN 423496 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
PH Family Medicine-BishopvilleBishopville, SC, CCN 423497 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1740398080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402121",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842121",
            "telephone_number": "803-296-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 COLONIAL LIFE BLVD W",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107671",
            "telephone_number": "803-296-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH-MIDLANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP028",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prisma Health Hospice Midlands",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.