Self Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SELF MEDICAL GROUP

Doing business as

Clinton Family Medicine

Practice address

22580 Highway 76 E Ste 200
Laurens, SC 29360-8460

Phone

(864) 833-0055

NPI assigned

Jan 29, 2024

Last updated

Jan 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Tolbert Logan, MD

Title

Ceo

Phone

(864) 725-4780

Specialties & licenses 1

Addresses

Other names 1

• Clinton Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 3

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.

• Kristen Cain Beheler

  • Surgical Physician Assistant
  • Anderson, SC
  • NPI 1952951386
  NPD
• David Everett Feece, PA-C

  • Physician Assistant
  • Greenwood, SC
  • NPI 1245600956
  NPD
• Aubrey Susanne Hestir, PA-C

  • Physician Assistant
  • Greenwood, SC
  • NPI 1700538345
  NPD

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1467214049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E STE 200",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293608460",
            "telephone_number": "864-833-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E STE 200",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293608460",
            "telephone_number": "864-833-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TOLBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-725-4780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• SC Department of Juvenile Justice
• SC Regional Housing Authority No.1
• Scbma (Martha Franks Baptist Retirement Center)
• Jenna Michelle Schreiner, PA-C
• Self Medical Group
• Self Medical Group
• Self Medical Group
• Self Regional Healthcare (Self Medical Center Laurens)
• Self Regional Healthcare (Self Medical Center Laurens)
• Self Regional Physician Services (The Family Healthcare Center)

• Family Medicine Physician in Laurens, SC
• Providers in Laurens, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.