NPIMap

Cherokee Medical Center

Organization Active NPI Rural Health Clinic/Center · Gaffney, SC

NPI 1467093583 · NPPES record last updated Aug 19, 2021

Key facts

NPI
1467093583
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CHEROKEE MEDICAL CENTER
Practice address
517 Chesnee Hwy Ste a
Gaffney, SC 29341-2709
Phone
(864) 487-7655
Fax
(864) 487-8718
NPI assigned
Sep 30, 2019
Organization subpart
Yes
Parent organization (as reported)
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.

Authorized official

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

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same 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.

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

Facilities with the same owner 19

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

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Rural health clinic certification: CCN 423489

Legal name
CHEROKEE MEDICAL CENTER
Doing business as
CMC - CENTER FOR FAMILY MEDICINE - GRASSY POND
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 23, 2021
Last certification
Feb 8, 2023
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Enrollment address
517 Chesnee Hwy
Ste a
Gaffney, SC 29341-2709
Related CCNs
420043

All disclosed owners & managing parties 5

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 		Contracted Managing Employee
President of Cherokee Med Center		 Dec 10, 2020
Corporate Officer
President of Cherokee Med Center		 Dec 10, 2020
Operational/Managerial Control
President of Cherokee Med Center		 Dec 10, 2020
Apella Health Management Inc
Organization · Spartanburg, SC
Non-profit 		Operational/Managerial Control Dec 10, 2020
Elmer B Holstien
Individual 		Contracted Managing Employee
Ceo		 Dec 10, 2020
Corporate Officer
Ceo		 Dec 10, 2020
Operational/Managerial Control
Ceo		 Dec 10, 2020
Spartanburg Regional Health Services District Inc
Organization · Spartanburg, SC 		5% Or Greater Direct Ownership Interest Dec 10, 2020 100%
Bruce a Davis
Individual 		Corporate Officer
Senior VP, Cfo, District		 Dec 10, 2020
W-2 Managing Employee
Senior VP, Cfo, District		 Dec 10, 2020
Operational/Managerial Control
Senior VP, Cfo, District		 Dec 10, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20201230002246 SC Part a Provider - Rural Health Clinic 5991041212 Practice locations: Gaffney, SC

National Provider Directory

Tax ID family
Cherokee Medical Center (11 organizations share this tax ID)
Part of
Spartanburg Regional Health Services District Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

517 Chesnee Hwy Ste a
Gaffney, SC 29341-2709

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
RHC266MedicaidSC
42-3489OtherSCMEDICARE PIN

Other names

  • CMC-Center for Family Medicine-Grassy Pond Doing business as

Other providers in Gaffney, SC

All providers in Gaffney, SC · Rural Health Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.