PRISMA HEALTH-UPSTATE (NPI# 1366998460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366998460 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH-UPSTATE |
| Other Organization Name | PRISMA HEALTH CARDIOVASCULAR SVCS GRNV |
| Practice Address |
3 Butternut Dr Suite B4 Greenville SC 29605-4655 |
| Mailing Address |
1 Independence Pt Suite 212 Greenville SC 29615-4536 |
| Practice Telephone | 8644556900 |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2020-04-13 |
| Authorized Official Name | POLLY H. MILLER (VP PAYOR STRATEGIES & ALIGNMENT) |
| Authorized Official Telephone | 8645222286 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | HTL-0936 | SC | Hospitals |
| Other Name | Type Code |
|---|---|
| GHS Cardiovascular Svcs GRNV | Doing Business As Name - Organization |
| Prisma Health Cardiovascular Svcs GRNV | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396207221 | Prisma Health-upstate | Anesthesiology | 905 Verdae Blvd Ste 102, Greenville, SC 29607-4029 | 2019-04-01 |
| 1760963243 | Prisma Health-upstate | General Acute Care Hospital | 112 John St Ste 104, Easley, SC 29640-1405 | 2018-08-23 |
| 1578044053 | Prisma Health-upstate | General Acute Care Hospital | 11402 Anderson Rd Ste B, Greenville, SC 29611-7560 | 2018-08-23 |
| 1790264497 | Prisma Health-upstate | General Acute Care Hospital | 11404 Anderson Rd, Greenville, SC 29611 | 2018-08-13 |
| 1982159877 | Prisma Health-upstate | Clinic/Center | 741 Se Main St, Simpsonville, SC 29681-3237 | 2016-08-20 |
| 1205459443 | Prisma Health-upstate | Clinic/Center | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-05-22 |
| 1174161806 | Prisma Health-upstate | Clinic/Center | 11082 N Radio Station Rd, Seneca, SC 29678-1142 | 2019-12-12 |
| 1700424439 | Prisma Health-upstate | Clinic/Center | 12016 N Radio Station Rd, Seneca, SC 29678-1143 | 2019-12-12 |
| 1043857998 | Prisma Health-upstate | Clinic/Center | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2019-12-10 |
| 1932746815 | Prisma Health-upstate | Clinic/Center | 10110 Clemson Blvd, Seneca, SC 29678-0812 | 2019-12-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Prisma Health-Upstate | 300 E Mcbee Ave Suite 500, Greenville, SC 29601 |
| Street Address |
3 BUTTERNUT DR SUITE B4 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871598201 | Reginald John Brooker | Internal Medicine | 3 Butternut Dr, Ste B, Greenville, SC 29605-4653 | 2005-06-14 |
| 1669071791 | Amy Simpkins Robinson | Pharmacist | 3 Butternut Dr, Greenville, SC 29605-4655 | 2020-10-20 |
| 1659827756 | Prisma Health-upstate | General Acute Care Hospital | 3 Butternut Dr, Suite B, Greenville, SC 29605-4653 | 2016-08-29 |
| 1821403445 | Kendall Michelle Reid | Nurse Practitioner | 3 Butternut Dr, Suite B, Greenville, SC 29605-4655 | 2014-06-23 |
| 1548689672 | Greenville Health System | General Acute Care Hospital | 3 Butternut Dr, Suite B4, Greenville, SC 29605-4655 | 2014-04-16 |
| 1154603611 | Wimberly Tipping Cox | Nurse Practitioner | 3 Butternut Dr, Suite B, Greenville, SC 29605-4655 | 2011-09-12 |
| 1356674527 | Elizabeth Heritage Cull | Internal Medicine | 3 Butternut Dr, Suite B, Greenville, SC 29605-4655 | 2009-09-06 |
| 1861626764 | Lisa Marie Johnson-losinski | Nurse Practitioner | 3 Butternut Dr, Suite B, Greenville, SC 29605-4655 | 2009-05-06 |
| 1528264314 | Melissa A Saxon | Nurse Practitioner | 3 Butternut Dr, Suite B, Greenville, SC 29605-4655 | 2007-06-27 |
| 1447371281 | Sharmila Pravin Mehta | Internal Medicine | 3 Butternut Dr, Greenville, SC 29605-4655 | 2007-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578044053 | Prisma Health-upstate | General Acute Care Hospital | 11402 Anderson Rd Ste B, Greenville, SC 29611-7560 | 2018-08-23 |
| 1790264497 | Prisma Health-upstate | General Acute Care Hospital | 11404 Anderson Rd, Greenville, SC 29611 | 2018-08-13 |
| 1548716665 | Upstate Affiliate Organization | General Acute Care Hospital | 200 Andrews St, Suite 100, Greenville, SC 29601-3969 | 2016-08-29 |
| 1770903833 | Greenville Health System | General Acute Care Hospital | 13 Edgewood Dr, Greenville, SC 29605-4235 | 2014-04-16 |
| 1457771511 | Greenville Health System | General Acute Care Hospital | 1120 Grove Rd Ste B, Greenville, SC 29605-4652 | 2014-04-16 |
| 1992120851 | Greenville Health System | General Acute Care Hospital | 9 Doctors Dr, Greenville, SC 29605-4266 | 2014-02-28 |
| 1376899856 | St. Francis Hospital, Inc. | General Acute Care Hospital | 209 Patewood Dr Ste 300, Greenville, SC 29615-3592 | 2012-08-02 |
| 1598830697 | Oral Surgery Associates,pa | General Acute Care Hospital | 10 Enterprise Blvd Ste 209, Greenville, SC 29615-3554 | 2006-11-22 |
| 1568532513 | Greenville Health System | General Acute Care Hospital | 175 Patewood Dr, Greenville, SC 29615-3570 | 2006-11-08 |
| 1942386578 | Wj Barge Memorial Hospital | General Acute Care Hospital | 1700 Wade Hampton Blvd, Greenville, SC 29614-1000 | 2006-10-27 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.