NPIMap

Organization Active NPI

Cherokee Medical Center

Doing business as CMC-Center for Family Medicine-Peachview

  • Rural Health Clinic/Center
  • Gaffney, SC
National Provider Identifier
1376184499
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHEROKEE MEDICAL CENTER
Doing business as
CMC-Center for Family Medicine-Peachview
Practice address
722 Hyatt St Ste C
Gaffney, SC 29341-2644
Phone
(864) 487-2400
Fax
(864) 488-3987
NPI assigned
Sep 30, 2019
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Kenneth Meinke
Title
Chief Financial Officer
Phone
(864) 560-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

722 Hyatt St Ste C
Gaffney, SC 29341-2644

Mailing address

PO Box 277723
Atlanta, GA 30384-7723
Phone (864) 560-6000

Other identifiers 2

IdentifierTypeStateIssuer
RHC269MedicaidSC
42-3493OtherSCMEDICARE PIN

Other names 1

  • CMC-Center for Family Medicine-Peachview Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210726000482 SC Part A Provider - Rural Health Clinic 5991041212 Practice locations: Gaffney, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376184499. Details of each certification follow.

Rural health clinic certification: CCN 423493

Legal name
CHEROKEE MEDICAL CENTER
Doing business as
CMC - CENTER FOR FAMILY MEDICINE - PEACHVIEW
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 4, 2021
Last certification
Nov 4, 2021
Ownership / control type
2C
Organization structure
OtherNon-profit
Incorporated
May 1, 1995 in SC
Enrollment address
722 Hyatt St
Ste C
Gaffney, SC 29341-2644
Related CCNs
420043

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Cherokee Medical Center11 organizations share this tax ID, including this one
Part of
Spartanburg Regional Health Services District Inc

Other organizations with this tax ID 10

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Cody N Butts Individual Corporate OfficerPresident Jun 10, 2021
W-2 Managing EmployeePresident Jun 10, 2021
Operational/Managerial ControlPresident Jun 10, 2021
Apella Health Management Inc Organization, Spartanburg, SC Non-profit Operational/Managerial Control Jun 10, 2021
Mark a Aycock Individual Contracted Managing EmployeeChief Operating Officer Jun 10, 2021
Corporate OfficerChief Operation Officer Jun 10, 2021
Operational/Managerial ControlChief Operating Officer Jun 10, 2021
Elmer B Holstien Individual Contracted Managing EmployeeChief Executive Officer Jun 10, 2021
Corporate OfficerChief Executive Officer Jun 10, 2021
Operational/Managerial ControlChief Executive Officer Jun 10, 2021
Spartanburg Regional Health Services District Inc Organization, Spartanburg, SC 5% Or Greater Direct Ownership Interest Jun 10, 2021 100%
Kenneth J Meinke Individual Contracted Managing EmployeeChief Financial Officer Jun 10, 2021
Corporate OfficerChief Financial Officer Jun 10, 2021
Operational/Managerial ControlChief Financial Officer Jun 10, 2021
Bruce a Davis Individual Corporate OfficerSenior Vice President Jun 10, 2021
W-2 Managing EmployeeSenior Vice President Jun 10, 2021
Operational/Managerial ControlSenior Vice President Jun 10, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1376184499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847723",
            "telephone_number": "864-560-6000",
            "fax_number": "864-560-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HYATT ST STE C",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412644",
            "telephone_number": "864-487-2400",
            "fax_number": "864-488-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.",
        "enumeration_date": "2019-09-30",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "MEINKE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "864-560-6000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC269",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "42-3493",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC-Center for Family Medicine-Peachview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.