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Prisma Health-Upstate

Organization Active NPI Sleep Disorder Diagnostic Clinic/Center · Simpsonville, SC

NPI 1982159877 · NPPES record last updated Feb 5, 2021

Key facts

NPI
1982159877
Entity type
Organization (NPI type 2)
Primary specialty
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
Legal business name
PRISMA HEALTH-UPSTATE
Practice address
741 SE Main St
Simpsonville, SC 29681-3237
Phone
(864) 455-7743
NPI assigned
Aug 20, 2016
Organization subpart
No

Authorized official

Name
Polly H. Miller
Title
VP Payor Strategies & Alignment
Phone
(864) 522-2286

Other NPIs on the same Medicare enrollment 43

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

View all 43

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 784

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

View all 784

Medicare Care Compare: Hospital

Listed as
Prisma Health Hillcrest Hospital CCN 420037
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SC

Hospital certification: CCN 420037

Legal name
PRISMA HEALTH-UPSTATE
Doing business as
PRISMA HEALTH HILLCREST HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 11, 2021
Beds
43
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 2016 (1 total)
Organization structure
Other · Non-profit
Incorporated
Apr 1, 2019 in SC
Enrollment address
729 SE Main St
Simpsonville, SC 29681-3218
Other Hospital Practice Location
Hospital subgroups
General, Acute care

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 Director
Director, Provider Enrollment & Cvo		 Apr 5, 2020 100%
W-2 Managing Employee
Director, Provider Enrollment & Cvo		 Apr 5, 2020 100%
Polly H Miller
Individual 		Corporate Officer
SVP Finance, Enterprise Contracting		 Mar 20, 2020 100%
W-2 Managing Employee
SVP Finance, Enterprise Contracting		 Mar 20, 2020 100%
Operational/Managerial Control
SVP 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%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20161028000700 SC Part a Provider - Hospital 5698063162 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Simpsonville, SC
O20161222000767 SC Part B Supplier - Clinic/Group Practice 5698063162 Receives reassigned benefits from 438 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, SC; Greer, SC; Seneca, SC; Simpsonville, SC; Spartanburg, SC; Travelers Rest, SC; Clinton, SC; Easley, SC

National Provider Directory

Tax ID family
Upstate Affiliate Org (121 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Yes

Addresses

Primary practice location

741 SE Main St
Simpsonville, SC 29681-3237

Mailing address

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

Other names

  • Prisma Health Sleep Disorders Center-Hillcrest Doing business as

Other providers in Simpsonville, SC

All providers in Simpsonville, SC · Sleep Disorder Diagnostic Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.