Pruitthealth Hospice, Inc.
Organization Active NPI Inpatient Hospice · Columbia, SC
NPI 1790723435 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1790723435
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Inpatient Hospice 315D00000X
- Legal business name
- PRUITTHEALTH HOSPICE, INC.
- Practice address
- 903 Elmwood Ave Ste a
Columbia, SC 29201 - Phone
- (803) 771-0489
- NPI assigned
- Jun 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Neil L Pruitt Jr.
- Title
- Chairman and Ceo
- Phone
- (770) 279-6200
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 17
Corporate family (same tax ID) 24
Facilities with the same owner 123
Practitioners 42
-
Stacey Lynn Childress, AGPCNP
-
Kristin Claude, APRN
-
Erin Pruitt Drennon, FNP - BC
-
Jessica Marie Hellman, NURSE PRACTITIONER
-
Faye D Jennings, NP
-
Rhonda Rachels, APRN
-
Kimberlee Kay Saunders, AGPCNP
-
Sarah Simmons, APRN
-
Valorie M Bogue, NP-C
-
Ashley Brimmer, FNP-C
-
Ama Browne, NP
-
Cynthia Jill Martin Clark, FNP-C
-
Kendra Jordan Cook, APRN/NP
-
Rosa Credle, FNP
-
Jenna M Darby, MSN, FNP
-
Janet Annikki Dits-Rinta-Koski, RN, MSN, AGNP-C
-
Casi P Gilmer, FNP
Affiliated clinicians 12
-
Jason K Barber, M.D.
-
Ishan Bhansaly, M.D.
-
David Jonathan Budhoo, M.D.
-
Binyue Chang, M.D.
-
Conigliaro Jones, MD
-
Kerry Lewayne Wheeler, D.O.
-
Dennis Tambe Besong, M.D.
-
Chacey Bryan, M.D.
Medicare Care Compare: Hospice
- Listed as
- Pruitthealth Hospice- Columbia
- Ownership
- For-Profit
- Certified
- Apr 11, 2006
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Hospice certification: CCN 421565
- Legal name
- PRUITTHEALTH HOSPICE INC
- Doing business as
- PRUITTHEALTH HOSPICE-COLUMBIA
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 11, 2006
- Last certification
- Feb 25, 2022
- Ownership / control type
- Proprietary - Individual
- Organization structure
- Corporation · Proprietary
- Incorporated
- Oct 14, 1993 in GA
- Enrollment address
- 240 Stoneridge Dr
Ste 302
Columbia, SC 29210-8013
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Lance Danko |
W-2 Managing Employee | Oct 27, 2017 | 100% |
| Hannah Burris |
W-2 Managing Employee |
Oct 18, 2021 | |
| United Health Services Inc |
5% Or Greater Direct Ownership Interest | May 15, 2003 | 100% |
| Angela D. McCarn |
W-2 Managing Employee | Jul 1, 2020 | |
| Pruitthealth Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2022 | |
| Operational/Managerial Control | Jan 7, 2008 | ||
| Lisa P Hamby Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 28.84% |
| Neil Little Pruitt |
Corporate Officer | Apr 12, 1999 | |
| Corporate Director | Jan 3, 2006 | ||
| Neil L Pruitt Jr Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 35.19% |
| Teresa Sexton |
W-2 Managing Employee | Sep 19, 2019 | 100% |
| Uhs-Pruitt Holdings, Inc. |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 100% |
| Thomas R Beddingfield |
Corporate Director |
Sep 17, 2013 | |
| United Health Services of Georgia, Inc. |
5% Or Greater Direct Ownership Interest | Oct 31, 2003 | |
| J Paige Pruitt Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 31.32% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060103000094 | SC | Part a Provider - Hospice | 2264344217 |
3 other NPIs on this enrollment Practice locations: Columbia, SC; Anderson, SC; Greenville, SC |
National Provider Directory
- Tax ID family
- Pruitthealth Hospice Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Hospice | 315D00000X | Yes |
Addresses
Primary practice location
903 Elmwood Ave Ste a
Columbia, SC 29201
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other practice location 1
118 York St
Chester, SC 29706-1484
Phone (803) 385-2002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HSP073 | Medicaid | SC |
Other names
- PruittHealth Hospice - Columbia
Other providers in Columbia, SC
- Jessica Erin Hyatt Pruett
- Sallie I Prugh
- Pruitthealth - Columbia, LLC
- Pruitthealth Home Health, Inc.
- Pruitthealth Hospice, Inc.
- Pruitthealth Therapy Services, Inc.
- Jamion Pryor
- William Watkins Pryor Jr.
- Jacob Seth Psomiadis
- Psychology Services Center
All providers in Columbia, SC · Inpatient Hospice in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.