NPIMap

Organization Active NPI

Cherokee Medical Center

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

  • Rural Health Clinic/Center
  • Gaffney, SC
National Provider Identifier
1467093583
Registry record updated Aug 19, 2021
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-Grassy Pond
Practice address
517 Chesnee Hwy Ste a
Gaffney, SC 29341-2709
Phone
(864) 487-7655
Fax
(864) 487-8718
NPI assigned
Sep 30, 2019
Last updated
Aug 19, 2021By 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 Aug 19, 2021

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

517 Chesnee Hwy Ste a
Gaffney, SC 29341-2709

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
42-3489OtherSCMEDICARE PIN
RHC266MedicaidSC

Other names 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201230002246 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 1467093583. Details of each certification follow.

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
OtherNon-profit
Enrollment address
517 Chesnee Hwy
Ste a
Gaffney, SC 29341-2709
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 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 EmployeePresident of Cherokee Med Center Dec 10, 2020
Corporate OfficerPresident of Cherokee Med Center Dec 10, 2020
Operational/Managerial ControlPresident 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 EmployeeCeo Dec 10, 2020
Corporate OfficerCeo Dec 10, 2020
Operational/Managerial ControlCeo 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 OfficerSenior VP, Cfo, District Dec 10, 2020
W-2 Managing EmployeeSenior VP, Cfo, District Dec 10, 2020
Operational/Managerial ControlSenior VP, Cfo, District Dec 10, 2020

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1467093583",
    "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": "517 CHESNEE HWY STE A",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412709",
            "telephone_number": "864-487-7655",
            "fax_number": "864-487-8718"
        }
    ],
    "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": "2021-08-19",
        "certification_date": "2021-08-19",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "42-3489",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC266",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC-Center for Family Medicine-Grassy Pond",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMC-Center for Family Medicine-Grassy Pond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.