NPIMap

Organization Active NPI

Spartanburg Medical Center

Doing business as Medical Group of the Carolinas - Weight Loss Services - Spartanburg

  • Surgery Physician
  • Spartanburg, SC
National Provider Identifier
1417190646
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SPARTANBURG MEDICAL CENTER
Doing business as
Medical Group of the Carolinas - Weight Loss Services - Spartanburg
Practice address
100 E Wood St
Suite 202
Spartanburg, SC 29303-3004
Phone
(864) 560-7070
Fax
(864) 560-7073
NPI assigned
Apr 17, 2009
Last updated
Jan 13, 2023By 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 Jan 13, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X SC Primary

Addresses

Primary practice location

100 E Wood St
Suite 202
Spartanburg, SC 29303-3004

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
GP1118MedicaidSC
5911569MedicaidNC

Other names 1

  • Medical Group of the Carolinas - Weight Loss Services - Spartanburg 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

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Practitioners & affiliated clinicians

Practitioners 8

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": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1417190646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "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": "100 E WOOD ST",
            "address_2": "SUITE 202",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033004",
            "telephone_number": "864-560-7070",
            "fax_number": "864-560-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC",
        "enumeration_date": "2009-04-17",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "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": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1118",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911569",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Group of the Carolinas - Weight Loss Services - Spartanburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Group of the Carolinas - Weight Loss Services - Spartanburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.