NPIMap

Organization Active NPI

Healogics Specialty Physicians of South Carolina, LLC

Doing business as Upstate Wound Care by Healogics

  • Clinic/Center
  • Spartanburg, SC
National Provider Identifier
1023677945
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF SOUTH CAROLINA, LLC
Doing business as
Upstate Wound Care by Healogics
Practice address
1630 Skylyn Drive
Suite 420
Spartanburg, SC 29307
Phone
(904) 446-3825
NPI assigned
Jun 13, 2019
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALOGICS SPECIALTY PHYSICIANS OF SOUTH CAROLINA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(904) 446-3519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1630 Skylyn Drive
Suite 420
Spartanburg, SC 29307

Mailing address

PO Box 638509
Cincinnati, OH 45263-8509

Other identifiers 1

IdentifierTypeStateIssuer
GP7200MedicaidSC

Other names 1

  • Upstate Wound Care by Healogics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Healogics

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140521002244 SC Part B Supplier - Clinic/Group Practice 8325261209 Receives reassigned benefits from 44 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spartanburg, SC; Walterboro, SC; Summerville, SC; North Charleston, SC; Myrtle Beach, SC; Lancaster, SC; Hilton Head Island, SC; Florence, SC…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Healogics Specialty Physicians of South Carolina LLC2 organizations share this tax ID, including this one
Part of
Healogics Specialty Physicians of South Carolina LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

989 Ribaut Rd
Ste 220
Beaufort, SC 29902
Phone (843) 522-5300

1580 Freedom Blvd
Ste 106
Florence, SC 29505
Phone (843) 661-0402

838 W Meeting St
Ste A
Lancaster, SC 29720
Phone (803) 285-2700

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1023677945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638509",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SKYLYN DRIVE",
            "address_2": "SUITE 420",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29307",
            "telephone_number": "904-446-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALOGICS SPECIALTY PHYSICIANS OF SOUTH CAROLINA, LLC",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-06-01",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7200",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Healogics",
            "affiliation": "N",
            "address_1": "1630 Skylyn Drive",
            "address_2": "Suite 420",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Upstate Wound Care by Healogics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.