NPIMap

Organization Active NPI

Self Regional Healthcare

Doing business as Family Healthcare Greenwood

  • Family Medicine Physician
  • Greenwood, SC
National Provider Identifier
1376335638
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SELF REGIONAL HEALTHCARE
Doing business as
Family Healthcare Greenwood
Practice address
116 Venture CT
Greenwood, SC 29649-8558
Phone
(864) 725-5594
Fax
(864) 725-5598
NPI assigned
May 21, 2025
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Matthew Tolbert Logan, MD
Title
President & Ceo
Phone
(864) 725-4780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

116 Venture CT
Greenwood, SC 29649-8558

Mailing address

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4673

Other names 1

  • Family Healthcare Greenwood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051214000767 SC Part B Supplier - Clinic/Group Practice 4082527742 Receives reassigned benefits from 234 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwood, SC; Clinton, SC; Ware Shoals, SC; Saluda, SC; Ninety Six, SC; Newberry, SC; MC Cormick, SC; Laurens, SC…

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Lawrence B Beasley MD49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

116 Venture Ct
Greenwood, SC 29649
Phone (864) 223-3100

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1376335638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4673",
            "fax_number": "864-725-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 VENTURE CT",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498558",
            "telephone_number": "864-725-5594",
            "fax_number": "864-725-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TOLBERT",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "864-725-4780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare Greenwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.