PRISMA HEALTH-UPSTATE (NPI# 1427504554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427504554 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH-UPSTATE |
| Other Organization Name | PRISMA HEALTH NORTH GREENVILLE LTACH |
| Practice Address |
807 N Main St Travelers Rest SC 29690-1551 |
| Mailing Address |
1 Independence Pt Suite 212 Greenville SC 29615-4536 |
| Practice Telephone | 8648345132 |
| 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 | 282E00000X | Long Term Care Hospital | HTL-0935 | SC | Hospitals |
| Other Name | Type Code |
|---|---|
| GHS North Greenville LTACH | Doing Business As Name - Organization |
| Prisma Health North Greenville LTACH | 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 |
807 N MAIN ST |
| City | TRAVELERS REST |
| State | SC |
| Zip Code | 29690-1551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951550 | Dina C Graham | Pharmacist | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-10-28 |
| 1376142992 | Dinah Jankovic | Pharmacist | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-10-24 |
| 1336767730 | Audrey Denise Goodjoin | Nurse Practitioner | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-07-12 |
| 1205459443 | Prisma Health-upstate | Clinic/Center | 807 N Main St, Travelers Rest, SC 29690-1551 | 2020-05-22 |
| 1376752410 | Laura H. Turman | Pharmacist | 807 N Main St, Travelers Rest, SC 29690-1551 | 2007-05-22 |
| 1952445207 | Katherine Gosnell Morgan | Pharmacist | 807 N Main St, Travelers Rest, SC 29690-1551 | 2007-02-19 |
| 1982657953 | Greenville Health System | Long Term Care Hospital | 807 N Main St, Travelers Rest, SC 29690-1551 | 2006-05-18 |
| 1417907924 | Greenville Health System | Special Hospital | 807 N Main St, Travelers Rest, SC 29690-1551 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063709 | Act Medical Transport Services LLC | Private Vehicle | 316 Poplar St Ext, Travelers Rest, SC 29690 | 2020-11-04 |
| 1881180297 | Tonya Cheeks | Home Health Aide | 20 S Poinsett Hwy Ste C, Travelers Rest, SC 29690 | 2018-07-09 |
| 1811391683 | Dialysis Newco, Inc | Clinic/Center | 36 South Main Street, Travelers Rest, SC 29690 | 2014-10-22 |
| 1356762835 | Maura Smith | Pharmacist | 1500 Seer Highway Ingles Pharmacy, Travelers Rest, SC 29690 | 2013-12-30 |
| 1174873400 | Regena Leeann Morgan | Pharmacist | 200 Hwy 25 North, Travelers Rest, SC 29690 | 2012-09-13 |
| 1316187040 | William Matthew Fisher | Psychiatry & Neurology | One Havenwood Lane, Travelers Rest, SC 29690 | 2009-02-20 |
| 1437303625 | Deborah Ann Arnold | Speech-Language Pathologist | 130 Echo Lane, Travelers Rest, SC 29690 | 2008-11-14 |
| 1124299375 | Preserve Health, Pa | Family Medicine | 135 Botanical Circle, Travelers Rest, SC 29690 | 2008-03-17 |
| 1962627372 | Mcleskey Todd Pharmacy of Travelers Rest, Inc | Durable Medical Equipment & Medical Supplies | 32 South Main St, Travelers Rest, SC 29690 | 2007-04-13 |
| 1730231408 | Jon Michael Julian | Dentist | 125 Botanical Circle, Travelers Rest, SC 29690 | 2007-01-16 |
| Find all providers in zip 29690 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982657953 | Greenville Health System | Long Term Care Hospital | 807 N Main St, Travelers Rest, SC 29690-1551 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871824532 | Colleton Courtyard | Long Term Care Hospital | 210 Academy Rd, Walterboro, SC 29488-9208 | 2010-01-20 |
| 1992993109 | Dallas Southeast Long Term Acute Care, LLC | Long Term Care Hospital | 1824 1st Dr, Charleston, SC 29407-5756 | 2007-10-12 |
| 1396747929 | Regency Hospital of Greenville, LLC | Long Term Care Hospital | 3 Saint Francis Dr, Suite 440, Greenville, SC 29601-3971 | 2005-08-12 |
| 1487656294 | Regency Hospital Company of South Carolina, LLC | Long Term Care Hospital | 121 E Cedar St, 4th and 5th Floor, Florence, SC 29504 | 2005-08-11 |
| 1770096216 | Continuecare Hospital At Palmetto Health Baptist, Inc. | Long Term Care Hospital | 1519 Marion St, Columbia, SC 29201-2910 | 2017-11-07 |
| 1831638238 | Continuecare Hospital At Palmetto Health Baptist, Inc. | Long Term Care Hospital | Taylor At Marion St, Columbia, SC 29220-0001 | 2017-02-17 |
| 1578904322 | Vibra Hospital of Charleston LLC | Long Term Care Hospital | 1200 Hospital Dr, 3rd Floor, Mt Pleasant, SC 29464-3251 | 2013-07-09 |
| City | TRAVELERS REST |
| Zip Code | 29690 |
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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.