NPIMap

Organization Active NPI

Regenesis Organization Community Health Center

Doing business as Regenesis Health Care

  • Federally Qualified Health Center (FQHC)
  • Duncan, SC
National Provider Identifier
1225899594
Registry record updated Jan 23, 2024
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
Doing business as
Regenesis Health Care
Practice address
1663 E Main St
Duncan, SC 29334-9217
Phone
(864) 582-2411
Fax
(864) 594-0040
NPI assigned
Jan 23, 2024
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Marlon Hunter
Title
Ce0
Phone
(864) 594-0190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1663 E Main St
Duncan, SC 29334-9217

Mailing address

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

Other names 1

  • REGENESIS HEALTH CARE Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240514001368 SC Part A Provider - Federally Qualified Health Center (FQHC) 8022928001 Practice locations: Duncan, SC
O20250813003402 SC Part B Supplier - Clinic/Group Practice 8022928001 Receives reassigned benefits from 1 practitioner
Practice locations: Duncan, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225899594. Details of each certification follow.

Federally qualified health center certification: CCN 421099

Legal name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Doing business as
REGENESIS HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 5, 2024
Last certification
Jun 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1663 E Main St
Duncan, SC 29334-9217

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Regenesis Org Comm HLTH Ctr11 organizations share this tax ID, including this one
Part of
Regenesis Org Comm HLTH Ctr

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Marlon Hunter Individual Corporate OfficerCeo Aug 1, 2018
W-2 Managing Employee Aug 1, 2018

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1225899594",
    "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": "864-594-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 E MAIN ST",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349217",
            "telephone_number": "864-582-2411",
            "fax_number": "864-594-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "MARLON",
        "authorized_official_title_or_position": "CE0",
        "authorized_official_telephone_number": "864-594-0190"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REGENESIS HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duncan, SC

Sources for this page

Verify at the official NPI Registry.