NPIMap

Organization Active NPI

Pelham Medical Center

  • General Acute Care Hospital
  • Greer, SC
National Provider Identifier
1982800397
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HTL-0905 Issued in SC
Legal business name
PELHAM MEDICAL CENTER
Practice address
250 Westmoreland Rd
Greer, SC 29651-9013
Phone
(864) 530-6000
Fax
(864) 530-4665
NPI assigned
Jun 22, 2007
Last updated
Mar 31, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Authorized official

Name
Mr. Kenneth James Meinke
Title
Cfo
Phone
(864) 560-6103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HTL-0905 SC Primary

Addresses

Primary practice location

250 Westmoreland Rd
Greer, SC 29651-9013

Mailing address

PO Box 198886
Atlanta, GA 30384-8886
Phone (864) 560-4123

Other identifiers 5

IdentifierTypeStateIssuer
795944823AMedicaidGA
A00905MedicaidSC
4200103MedicaidNC
B00905MedicaidSC
GP4916MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090408000072 SC Part A Provider - Hospital 2365519097 1 other NPI on this enrollment
Practice locations: Simpsonville, SC; Greer, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982800397. Details of each certification follow.

Hospital certification: CCN 420103

Legal name
PELHAM MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 16, 2008
Last certification
Jan 19, 2022
Beds
48
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
May 1, 1995 in SC
Enrollment address
2755 South Highway 14
Suite 1400
Greer, SC 29650-4931
Hospital subgroups
Acute care, Short-term

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Pelham Medical CenterCCN 420103 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Village Hospital4 organizations share this tax ID, including this one
Part of
Spartanburg Regional Health Services District Inc

Other organizations with this tax ID 3

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elmer B Holstien Individual Corporate OfficerCeo Aug 1, 2011
W-2 Managing EmployeeCeo Aug 1, 2011
Operational/Managerial ControlCeo Aug 1, 2011
Spartanburg Regional Health Services District Inc Organization, Spartanburg, SC 5% Or Greater Direct Ownership Interest Oct 8, 2008 100%
Charles E Morrow Individual W-2 Managing EmployeeChief Medical Officer - Medical Aff Dec 4, 2023
Operational/Managerial ControlChief Medical Officer - Medical Aff Dec 4, 2023
Bruce a Davis Individual Corporate OfficerCfo Jan 25, 2020
W-2 Managing EmployeeCfo Jan 25, 2020
Operational/Managerial ControlCfo Jan 25, 2020
Anthony Thomas Kouskolekas Individual Corporate OfficerPresident Sep 4, 2012
W-2 Managing EmployeePresident Sep 4, 2012
Operational/Managerial ControlPresident Sep 4, 2012

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

Affiliated clinicians 630

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

View all 630

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1982800397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198886",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848886",
            "telephone_number": "864-560-4123",
            "fax_number": "864-560-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WESTMORELAND RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296519013",
            "telephone_number": "864-530-6000",
            "fax_number": "864-530-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC",
        "enumeration_date": "2007-06-22",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "MEINKE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-560-6103",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL-0905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "795944823A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A00905",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4200103",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B00905",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4916",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.