NPIMap

Organization Active NPI

Synergy Spine Center, PA

  • Ambulatory Surgical Clinic/Center
  • Seneca, SC
National Provider Identifier
1013996750
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SYNERGY SPINE CENTER, PA
Practice address
457D by Pass 123
Seneca, SC 29678
Phone
(864) 882-8850
Fax
(864) 882-0420
NPI assigned
Jan 11, 2006
Last updated
Apr 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Marion R McMillan III, MDNPI 1427037167
Title
Medical Director Owner
Phone
(864) 882-8850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

457D by Pass 123
Seneca, SC 29678

Mailing address

457D by Pass 123
Seneca, SC 29678-0842
Phone (864) 882-8850

Other identifiers 1

IdentifierTypeStateIssuer
ASC039MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100224000752 SC Part B Supplier - Ambulatory Surgical Center 8325182694 Receives reassigned benefits from 8 practitioners
Practice locations: Seneca, SC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Synergy Spine CenterCCN 42C0001042
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

457 Highway 123
#D
Seneca, SC 29678
Phone (864) 882-8850

457D By Pass 123
Seneca, SC 29678
Phone (864) 882-8850

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1013996750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457D BY PASS 123",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296780842",
            "telephone_number": "864-882-8850",
            "fax_number": "864-886-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457D BY PASS 123",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "29678",
            "telephone_number": "864-882-8850",
            "fax_number": "864-882-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY SPINE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR OWNER",
        "authorized_official_telephone_number": "864-882-8850",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC039",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.