NPIMap

Organization Active NPI

Regenesis Organization Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Spartanburg, SC
National Provider Identifier
1194710426
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Practice address
750 S. Church Street
Spartanburg, SC 29306
Phone
(864) 582-2411
Fax
(864) 582-7179
NPI assigned
Sep 13, 2005
Last updated
Sep 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Authorized official

Name
Marlon Hunter
Title
Ceo
Phone
(864) 582-2817

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

750 S. Church Street
Spartanburg, SC 29306

Mailing address

PO Box 5158
Spartanburg, SC 29304-5158
Phone (864) 582-2411

Other practice location 1

764 N Church St
Spartanburg, SC 29303-3097
Phone (864) 582-2411

Other practice location 2

16922 Telge Rd Ste 2J
Cypress, TX 77429-1108
Phone (210) 316-1796

Other identifiers 1

IdentifierTypeStateIssuer
FQC057MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030630000013 SC Part A Provider - Federally Qualified Health Center (FQHC) 8022928001 Practice locations: Spartanburg, SC
O20050127000120 SC Part B Supplier - Clinic/Group Practice 8022928001 Receives reassigned benefits from 97 practitioners
4 other NPIs on this enrollment
Practice locations: Gaffney, SC; Spartanburg, SC; Woodruff, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194710426. Details of each certification follow.

Federally qualified health center certification: CCN 421878

Legal name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Doing business as
REGENESIS HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 22, 2003
Last certification
May 22, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 30, 1998 in SC
Enrollment address
750 S Church St
Spartanburg, SC 29306-5348

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hunter Dawkins Individual Corporate DirectorBoard Member Mar 1, 2020
Holly Ann Savage Individual Corporate Director Mar 1, 2019
Catrina Smith Individual Corporate DirectorBoard Member Mar 1, 2021
Marlon Hunter Individual Corporate OfficerCeo Aug 1, 2018 100%
Katherine Henderson Individual Corporate DirectorBoard Member Mar 1, 2021
Stephanie Coln Individual Corporate DirectorBoard Member Mar 1, 2018
Lashann Long Individual W-2 Managing Employee Jun 12, 2017
Valerie Sullivan Individual Corporate DirectorBoard Member Mar 1, 2018

Practitioners & affiliated clinicians

Practitioners 102

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 102

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788739200000",
    "number": "1194710426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5158",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293045158",
            "telephone_number": "864-582-2411",
            "fax_number": "864-582-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S. CHURCH STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29306",
            "telephone_number": "864-582-2411",
            "fax_number": "864-582-7179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "764 N Church St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033097",
            "country_code": "US",
            "telephone_number": "864-582-2411",
            "fax_number": "864-582-2829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16922 Telge Rd Ste 2J",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774291108",
            "country_code": "US",
            "telephone_number": "210-316-1796",
            "fax_number": "864-582-7178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "MARLON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-582-2817"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC057",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.