NPIMap

Organization Active NPI

Regenesis Organization Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Gaffney, SC
National Provider Identifier
1245409846
Registry record updated Jul 21, 2022
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
1341 N Limestone St
Gaffney, SC 29340-4733
Phone
(864) 582-2411
Fax
(864) 487-8734
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 1

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

Addresses

Primary practice location

1341 N Limestone St
Gaffney, SC 29340-4733

Mailing address

PO Box 5158
Spartanburg, SC 29304-5158
Phone (864) 582-2817

Other identifiers 1

IdentifierTypeStateIssuer
FQC057MedicaidSC

Other names 2

  • Gaffney Medical Center Doing business as
  • 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
O20050127000120 SC Part B Supplier - Clinic/Group Practice 8022928001 Receives reassigned benefits from 97 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gaffney, SC; Spartanburg, SC; Woodruff, SC
O20090304000455 SC Part A Provider - Federally Qualified Health Center (FQHC) 8022928001 Practice locations: Gaffney, SC

Federally qualified health center certification: CCN 421906

Legal name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 2009
Last certification
May 1, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 13, 1999 in SC
Enrollment address
1341 N Limestone St
Gaffney, SC 29340-4733

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
Tax ID family
Regenesis Organization11 organizations share this tax ID, including this one

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 2

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 100%
Cheryl a Rivers Individual W-2 Managing EmployeeBilling Director Nov 13, 2012

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245409846",
    "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": "864-582-2817",
            "fax_number": "864-582-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N LIMESTONE ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293404733",
            "telephone_number": "864-582-2411",
            "fax_number": "864-487-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-27",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC057",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gaffney Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ReGenesis Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ReGenesis Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.