NPIMap

Organization Active NPI

Spartanburg Regional Medical Ctr

Doing business as Village Orthopaedic Surgery-Mauldin

  • Orthopaedic Surgery Physician
  • Greenville, SC
National Provider Identifier
1316190952
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPARTANBURG REGIONAL MEDICAL CTR
Doing business as
Village Orthopaedic Surgery-Mauldin
Practice address
535 W Butler Rd Ste C
Greenville, SC 29607-4833
Phone
(864) 277-9867
Fax
(864) 849-9394
NPI assigned
Oct 28, 2008
Last updated
Jul 29, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Mark Aycock
Title
Executive Vice President
Phone
(864) 560-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

535 W Butler Rd Ste C
Greenville, SC 29607-4833

Mailing address

PO Box 2168
Spartanburg, SC 29304-2168
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
CN1627OtherSCMEDICARE RR
GP1118MedicaidSC

Other names 1

  • Village Orthopaedic Surgery-Mauldin Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 48

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

View all 48

National Provider Directory

National Provider Directory
Tax ID family
Wellford Family Medicine136 organizations share this tax ID, including this one
Part of
Spartanburg Regional Health Services District Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1330 Boiling Springs Rd
Ste 1540
Spartanburg, SC 29303
Phone (864) 560-2663

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1316190952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293042168",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W BUTLER RD STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074833",
            "telephone_number": "864-277-9867",
            "fax_number": "864-849-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG REGIONAL MEDICAL CTR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC",
        "enumeration_date": "2008-10-28",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "AYCOCK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "864-560-6000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CN1627",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1118",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Orthopaedic Surgery-Mauldin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.