NPIMap

Organization Active NPI

Newberry County Memorial Hospital

Doing business as Newberry Medical Center of Newberry College

  • Family Medicine Physician
  • Newberry, SC
National Provider Identifier
1043990807
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEWBERRY COUNTY MEMORIAL HOSPITAL
Doing business as
Newberry Medical Center of Newberry College
Practice address
1910A College St
Newberry, SC 29108-2644
Phone
(803) 405-7469
Fax
(803) 276-6885
NPI assigned
Jul 18, 2023
Last updated
Jul 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
John Walter PughNPI 1265613376
Title
Board Member
Phone
(803) 364-2310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1910A College St
Newberry, SC 29108-2644

Mailing address

1910A College St
Newberry, SC 29108-2644
Phone (803) 405-7469

Other names 1

  • Newberry Medical Center of Newberry College Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000264 SC Part B Supplier - Clinic/Group Practice 8123927464 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Mountain, SC; Whitmire, SC; Newberry, SC

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

99 N Mill St
Little Mtn, SC 29075
Phone (803) 405-7555

1830 Pondfield Rd
Ste A3
Newberry, SC 29108
Phone (803) 405-7140

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1043990807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910A COLLEGE ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082644",
            "telephone_number": "803-405-7469",
            "fax_number": "803-276-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910A COLLEGE ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082644",
            "telephone_number": "803-405-7469",
            "fax_number": "803-276-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "803-364-2310"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newberry Medical Center of Newberry College",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newberry, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.