NPIMap

Organization Active NPI

Regenesis Organization Community Health Center

Doing business as Woodruff Medical Center

  • Federally Qualified Health Center (FQHC)
  • Woodruff, SC
National Provider Identifier
1265777908
Registry record updated Apr 30, 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
Doing business as
Woodruff Medical Center
Practice address
220 Irby St
Woodruff, SC 29388-1618
Phone
(864) 582-2411
Fax
(864) 670-9414
NPI assigned
Dec 6, 2012
Last updated
Apr 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

220 Irby St
Woodruff, SC 29388-1618

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
FQC173MedicaidSC

Other names 1

  • Woodruff Medical Center 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
O20130320000341 SC Part A Provider - Federally Qualified Health Center (FQHC) 8022928001 Practice locations: Woodruff, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265777908. Details of each certification follow.

Federally qualified health center certification: CCN 421003

Legal name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 2, 2013
Last certification
Apr 2, 2013
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
220 Irby Street
Woodruff, SC 29388-1618

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 Org Comm HLTH Ctr11 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEHGBD

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 Oct 15, 2012

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1265777908",
    "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": "220 IRBY ST",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293881618",
            "telephone_number": "864-582-2411",
            "fax_number": "864-670-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC173",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodruff Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodruff, SC

Sources for this page

Verify at the official NPI Registry.