PRISMA HEALTH-UPSTATE (NPI# 1679029771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679029771 |
| Entity Type | Organization |
| Organization Name | PRISMA HEALTH-UPSTATE |
| Other Organization Name | PRISMA HEALTH CANCER INST-EASTSIDE |
| Practice Address |
65 International Dr Greenville SC 29615-4816 |
| Mailing Address |
1 Independence Pt Suite 212 Greenville SC 29615-4536 |
| Practice Telephone | 8649877000 |
| 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 Cancer Inst-Eastside | Doing Business As Name - Organization |
| Prisma Health Cancer Inst-Eastside | 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 |
65 INTERNATIONAL DR |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29615-4816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851793 | Kim Ong Gococo | Internal Medicine | 65 International Dr, Greenville, SC 29615-4816 | 2005-06-15 |
| 1811402399 | Savannah Stroud Hightower | Nurse Practitioner | 65 International Dr, Greenville, SC 29615-4816 | 2017-12-06 |
| 1851833974 | Jennifer Ramsey Garren | Nurse Practitioner | 65 International Dr, Greenville, SC 29615-4816 | 2016-11-07 |
| 1093127318 | Priscilla Faye Massey | Nurse Practitioner | 65 International Dr, Greenville, SC 29615-4816 | 2014-05-21 |
| 1982023131 | Greenville Health System | General Acute Care Hospital | 65 International Dr, Greenville, SC 29615-4816 | 2014-04-15 |
| 1164672945 | Susan Bailey Wells | Physician Assistant | 65 International Dr, Greenville, SC 29615-4816 | 2008-09-29 |
| 1568664480 | Suzanne Reim Fanning | Internal Medicine | 65 International Dr, Greenville, SC 29615-4816 | 2007-06-04 |
| 1679593966 | Britt Haley Bolemon | Internal Medicine | 65 International Dr, Greenville, SC 29615-4816 | 2006-07-20 |
| 1134125818 | Saeeda Zaman Chowdhury | Internal Medicine | 65 International Dr, Greenville, SC 29615-4816 | 2005-06-27 |
| 1164428397 | Lisa Cunningham Smith | Nurse Practitioner | 65 International Dr, Greenville, SC 29615-4816 | 2005-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
| 1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
| 1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
| 1255816070 | Trevis L Cureton | Pharmacist | 2401 East North St, Greenville, SC 29615 | 2018-09-27 |
| 1497232565 | Jacob J Fountain | Nurse Practitioner | 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 | 2018-07-23 |
| 1346726924 | St. Francis Physician Services, Inc | Internal Medicine | 5 Hoke Smith Blvd, Greenville, SC 29615 | 2018-07-17 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1316466543 | Mariah Hope Mosher | Behavioral Analyst | 7 Mckenna Commons Court, Greenvilee, SC 29615 | 2017-09-19 |
| 1326400896 | Karen L Heaps | Counselor | 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 | 2016-03-24 |
| 1134589013 | Sharon Erk | Technician, Other | 2950 E.norths St, Greenville, OH 29615 | 2016-03-04 |
| Find all providers in zip 29615 | ||||
| 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 | 29615 |
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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.