Self Regional Healthcare Partners
Organization Active NPI Family Medicine Physician · Edgefield, SC
NPI 1053929208 · NPPES record last updated May 27, 2026
Key facts
- NPI
- 1053929208
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SELF REGIONAL HEALTHCARE PARTNERS
- Practice address
- 155 Ridge Medical Plaza Rd
Edgefield, SC 29824-4531 - Phone
- (803) 637-3146
- Fax
- (803) 637-6597
- NPI assigned
- Jul 14, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Matthew T Logan, MD
- Title
- President and Ceo
- Phone
- (864) 725-4253
Other NPIs on the same Medicare enrollment 4
Member of 1
Practitioners 35
-
Anas Abdel Azim, M.D., M.SC
-
Steven M Andreasen, DPM
-
Alexander Barnett, DPM
-
Ryan Joseph Bolt, DO
-
Andrea Branyon, APRN, FNP-BC
-
Guy Smith Dooley IV, D.O.
-
Scott W Gibson, MD
-
Todd C Hansen, M.D.
-
Casey Cummings Holliday, DNP, FNP-C
-
Scot Heath Jones, M.D.
-
Shana S Keller, APRN
-
Kelly L Mandile, DPM
-
Davis Renee Migdalas, FNP
-
Zane R Newton, APRN
-
George L Rainsford, M.D.
-
Ralph N Riley, M.D.
-
Brent R Schoen, M.D.
-
Anthony R Timms, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190129003656 | SC | Part B Supplier - Clinic/Group Practice | 1557606118 |
Receives reassigned benefits from 133 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Edgefield, SC; Johnston, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Sports Medicine (Family Medicine) Physician |
207QS0010X | |||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Otolaryngology Physician |
207Y00000X | |||
| Surgery Physician |
208600000X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Urology Physician |
208800000X | |||
| Foot & Ankle Surgery Podiatrist |
213ES0103X |
Addresses
Primary practice location
155 Ridge Medical Plaza Rd
Edgefield, SC 29824-4531
Mailing address
1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111
Other names
- Edgefield Medical Center
Other providers in Edgefield, SC
- River Road Care
- Julian Thomas Rushin
- Kathleen M Ryan
- David Anthony Sandoval
- SC-Ga2018 the Ridge Rehabilitation and Healthcare Center, LLC
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
All providers in Edgefield, 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 May 27, 2026. 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.