Organization Active NPI

Anmed Enterprises Inc - Upstate Endoscopy Center Inc LLC

Doing business as Upstate Endoscopy

  • Endoscopy Clinic/Center
  • Anderson, SC
National Provider Identifier
1881645810
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
ANMED ENTERPRISES INC - UPSTATE ENDOSCOPY CENTER INC LLC
Doing business as
Upstate Endoscopy
Practice address
1922B McConnell Springs Rd
Anderson, SC 29621-2642
Phone
(864) 716-6555
Fax
(864) 716-6599
NPI assigned
May 15, 2006
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
David Wortham, MDNPI 1437101771
Title
MD
Phone
(864) 716-6555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1922B McConnell Springs Rd
Anderson, SC 29621-2642

Mailing address

1922B McConnell Springs Rd
Anderson, SC 29621-2642
Phone (864) 716-6555

Other identifiers 1

IdentifierTypeStateIssuer
ASC055MedicaidSC

Other names 1

  • Upstate Endoscopy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701001336 SC Part B Supplier - Ambulatory Surgical Center 8729065271 Practice locations: Anderson, SC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Anmed Enterprises Inc Upstate Endoscopy Center Inc LLCCCN 42C0001055
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1026162Upstate Endoscopy Center LLC Dba Upstate Endoscopy1922 McConnell Springs Suite B, Anderson, SC 29621Certificate of waiverMay 26, 2028

National Provider Directory

National Provider Directory

Locations

1922 McConnell Springs Rd
#B
Anderson, SC 29621
Phone (864) 716-6555

1922 McConnell Springs Rd
Ste B
Anderson, SC 29621
Phone (864) 716-6555

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1881645810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922B MCCONNELL SPRINGS RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212642",
            "telephone_number": "864-716-6555",
            "fax_number": "864-716-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922B MCCONNELL SPRINGS RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212642",
            "telephone_number": "864-716-6555",
            "fax_number": "864-716-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANMED ENTERPRISES INC - UPSTATE ENDOSCOPY CENTER INC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "WORTHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "864-716-6555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC055",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upstate Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.