Newberry County Memorial Hospital
Organization Active NPI Family Medicine Physician · Newberry, SC
NPI 1043990807 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1043990807
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NEWBERRY COUNTY MEMORIAL HOSPITAL
- Practice address
- 1910A College St
Newberry, SC 29108-2644 - Phone
- (803) 405-7469
- Fax
- (803) 276-6885
- NPI assigned
- Jul 18, 2023
- Organization subpart
- No
Authorized official
- Name
- John Walter Pugh
- Title
- Board Member
- Phone
- (803) 364-2310
Other NPIs on the same Medicare enrollment 5
Practitioners 12
-
Tamara S Baker, APRN, FNP-C
-
Stephen Paul Bayuk, D.O.
-
Emily Sue Livingston, FNP
-
Lauren M Powell, NP-C
-
John M Thompson, M.D
-
Rebecca L White, M.D.
-
Gregory E Barefoot, P.A.C.
-
Nicholas Kent Petrus, PA-C
-
Casey Hendrix Purcell, NP-C
-
Laurel Susan Stacey, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
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
- Newberry Medical Center of Newberry College
Other providers in Newberry, SC
- Newberry County Disabilities and Special Needs Board
- Newberry County Disabilities and Special Needs Board
- Newberry County EMS
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
All providers in Newberry, SC · Family Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.