Spartanburg Medical Center
Organization Active NPI Obstetrics & Gynecology Physician · Boiling Springs, SC
NPI 1245815380 · NPPES record last updated Apr 5, 2021
Key facts
- NPI
- 1245815380
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- SPARTANBURG MEDICAL CENTER
- Practice address
- 3981 Highway 9 Ste 201
Boiling Springs, SC 29316-8578 - Phone
- (864) 278-1400
- Fax
- (864) 278-1418
- NPI assigned
- Mar 10, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Authorized official
- Name
- Kenneth J Meinke
- Title
- Cheif Financial Officer
- Phone
- (864) 560-6103
Other NPIs on the same Medicare enrollment 48
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040108000827 | SC | Part B Supplier - Clinic/Group Practice | 3072425297 |
Receives reassigned benefits from 324 practitioners 48 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spartanburg, SC; Union, SC; Simpsonville, SC; Boiling Springs, SC; Gaffney, SC; Greenville, SC; Greer, SC |
National Provider Directory
- Part of
- Spartanburg Regional Health Services District Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
3981 Highway 9 Ste 201
Boiling Springs, SC 29316-8578
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PG0339 | Medicaid | SC | |
| 6162 | Other | SC | MEDICARE PIN |
Other names
- Medical Groupof theCarolinas-PiedmontWomen'sHealthcare-Boiling Springs
Other providers in Boiling Springs, SC
- Sydney Smith
- Soumco LLC
- South Carolina CVS Pharmacy LLC
- South Carolina CVS Pharmacy LLC
- Spartanburg Medical Center
- Spartanburg Regional Med Ctr
- Spartanburg School District 2
- Michael Spaulding
- Katherine Mitchum Spinks
- Melissa Stiling
All providers in Boiling Springs, SC · Obstetrics & Gynecology 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 Apr 5, 2021. 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.