UPSTATE AFFILIATE ORGANIZATION (NPI# 1831639459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831639459 |
| Entity Type | Organization |
| Organization Name | UPSTATE AFFILIATE ORGANIZATION |
| Other Organization Name | GHS KIDNETICS - SPARTANBURG |
| Practice Address |
249 N Grove Medical Park Dr #300 Spartanburg SC 29303-4227 |
| Mailing Address |
1 Independence Pt Suite 212 Greenville SC 29615-4545 |
| Practice Telephone | 8645980420 |
| Practice Fax Number | 8645980431 |
| Mailing Telephone | 8647976307 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | SPENCE M TAYLOR (EXECUTIVE - CORPORATE) |
| Authorized Official Telephone | 8647976118 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
HTL-0936 | SC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| GHS Kidnetics - Spartanburg | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548716665 | Upstate Affiliate Organization | General Acute Care Hospital | 200 Andrews St, Suite 100, Greenville, SC 29601-3969 | 2016-08-29 |
| 1811486764 | Upstate Affiliate Organization | General Acute Care Hospital | 109 Physicians Drive, Suite B, Greer, SC 29650 | 2018-05-07 |
| 1205382314 | Upstate Affiliate Organization | Skilled Nursing Facility | 22725 Highway 76 E, Clinton, SC 29325-7527 | 2016-08-29 |
| 1689120784 | Upstate Affiliate Organization | Home Health | 298 Memorial Dr, Seneca, SC 29672-9443 | 2016-08-29 |
| 1407301302 | Upstate Affiliate Organization | PACE Provider Organization | 32 Stoney Point Dr, Greenville, SC 29605-4628 | 2016-08-20 |
| Street Address |
249 N GROVE MEDICAL PARK DR #300 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303-4227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477608503 | Lisa A. Brown | Occupational Therapist | 249 N Grove Medical Park Dr, Spartanburg, SC 29303-4222 | 2007-01-25 |
| 1639646433 | Margaret Heijjer | Occupational Therapist | 249 N Grove Medical Park Dr, Spartanburg, SC 29303-4227 | 2018-10-30 |
| 1881135937 | Renee Kulik | Occupational Therapist | 249 N Grove Medical Park Dr, #300, Spartanburg, SC 29303-4227 | 2017-03-09 |
| 1558628172 | Jenny Thomas | Pediatrics | 249 N Grove Medical Park Dr, Suite 100, Spartanburg, SC 29303-4222 | 2012-04-20 |
| 1962738583 | Rebecca Michelle Saul | Nurse Practitioner | 249 N Grove Medical Park Dr, Spartanburg, SC 29303-4227 | 2009-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114561206 | Teresa White | Clinic/Center | 398 Old South Rd, Duncan, SC 29334-9266 | 2019-10-31 |
| 1144782640 | Williamsburg County Disabilities and Special Needs Board | Clinic/Center | 61 Greenlee St, Kingstree, SC 29556-6136 | 2019-04-03 |
| 1124414495 | Sunshine Pediatric Therapy of South Carolina | Clinic/Center | 5 Ivy Lawn Pl, Greenville, SC 29605-6522 | 2015-04-13 |
| 1225346737 | Carolina Developmental Clinic, LLC | Clinic/Center | 107 Vista Oaks Dr Ste C, Lexington, SC 29072-8230 | 2010-09-17 |
| 1396064382 | Palmetto Pediatric Ot, LLC | Clinic/Center | 2427 Old Lexington Highway, Chapin, SC 29036 | 2010-05-31 |
| 1023153996 | Medically Fragile Childrens Program | Clinic/Center | 2750 Speissegger Drive, Suite 108, N Charleston, SC 29405-8701 | 2007-02-20 |
| 1043394976 | Carolina Autism Supported Living Services | Clinic/Center | 4 Carriage Ln Ste 302, Charleston, SC 29407-6050 | 2006-10-25 |
| 1396291407 | Prisma Health-upstate | Clinic/Center | 29 N Academy St, Greenville, SC 29601-2629 | 2016-08-29 |
| 1336695436 | Prisma Health-upstate | Clinic/Center | 29 N Academy St, Greenville, SC 29601-2629 | 2016-08-29 |
| 1073521951 | Greenville Health System | Clinic/Center | 29 N Academy St, Greenville, SC 29601-2629 | 2006-08-04 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
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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.