NPIMap

Organization Active NPI

Regenesis Organization Community Health Center

Doing business as Regenesis Health Care

  • Federally Qualified Health Center (FQHC)
  • Spartanburg, SC
National Provider Identifier
1457061087
Registry record updated Jan 3, 2025
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
Regenesis Health Care
Practice address
945 E Main St Ste a
Spartanburg, SC 29302-2119
Phone
(864) 582-2411
NPI assigned
Dec 5, 2022
Last updated
Jan 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Authorized official

Name
Marlon Hunter
Title
Ceo
Phone
(864) 594-0190

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

945 E Main St Ste a
Spartanburg, SC 29302-2119

Mailing address

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

Other names 1

  • REGENESIS HEALTH CARE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@myrhc.org Direct REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240613002781 SC Part A Provider - Federally Qualified Health Center (FQHC) 8022928001 Practice locations: Spartanburg, SC
O20251010000966 SC Part B Supplier - Clinic/Group Practice 8022928001 Receives reassigned benefits from 1 practitioner
Practice locations: Spartanburg, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457061087. Details of each certification follow.

Federally qualified health center certification: CCN 421100

Legal name
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 14, 2024
Last certification
Jun 14, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationProprietary
Enrollment address
954 E Main St
Ste a
Spartanburg, SC 29302-2148

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Regenesis Organization11 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.

Locations

1663 E Main St
Duncan, SC 29334
Phone (846) 416-7933

945 E Main St
Ste A
Spartanburg, SC 29302

954 E Main St
Ste A
Spartanburg, SC 29302

Ownership & related parties

All disclosed owners & managing parties 1

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 Officer Aug 1, 2018
Corporate Director Aug 1, 2018
W-2 Managing Employee Aug 1, 2018

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1457061087",
    "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": "945 E MAIN ST STE A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022119",
            "telephone_number": "864-582-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "MARLON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-594-0190"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@myrhc.org",
            "affiliation": "Y",
            "endpointDescription": "EMAIL",
            "affiliationName": "REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "credentialing@myrhc.org",
            "address_1": "945 E Main St Ste A",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293022119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "REGENESIS HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.