NPIMap

Individual provider Active NPI

Eric Stephen Gwynn, MD

  • Urology Physician
  • Bluffton, SC
National Provider Identifier
1467586628
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35373 Issued in SC
Practice address
75 Baylor Dr Ste 205
Bluffton, SC 29910-8965
Phone
(843) 706-2255
Fax
(843) 706-2257
NPI assigned
Mar 16, 2007
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 110158 NC
Urology Physician 208800000X 35373 SC Primary

Addresses

Primary practice location

75 Baylor Dr Ste 205
Bluffton, SC 29910-8965

Mailing address

75 Baylor Dr Ste 205
Bluffton, SC 29910-8965
Phone (843) 706-2255

Other identifiers 1

IdentifierTypeStateIssuer
CF8401OtherVARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070706000320 VA Practitioner - Urology 7113027012 Reassigns benefits to 1 organization
I20130410000459 SC Practitioner - Urology 7113027012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Virginia Commonwealth University, School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

110 Akers Farm Rd
Christiansburg, VA 24073-4863
Phone (540) 382-9405

120 Akers Farm Rd
Christiansburg, VA 24073-4863
Phone (540) 382-3440

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4398

2900 Lamb Cir
Christiansburg, VA 24073-6344

2900 Lamb CR
Suite 7 700B
Christiansburg, VA 24073-6344
Phone (540) 731-7450

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

75 Baylor Dr
Suite 155
Bluffton, SC 29910-8965
Phone (843) 682-7480

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
110158NCMDUrology Physician
35373SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regional Medical Center of Orangeburg and Calhoun Counties Urology CurrentSince Jun 7, 2013 Accepting new patients
Self Medical Group CurrentSince May 19, 2018 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Jun 7, 2013 Accepting new patients
Hilton Head Regional Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Mar 21, 2016 Accepting new patients
Carilion Healthcare Corporation CurrentSince Mar 21, 2016 Accepting new patients
Hilton Head Regional Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
Self Medical Group CurrentSince May 19, 2018 Accepting new patients
Self Medical Group Current Accepting new patients
Hilton Head Regional Physician Group LLC Past Accepting new patients
Hardeeville Medical Group, LLC Past Accepting new patients
Hardeeville Medical Group, LLC Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Baylor Dr
Ste 155
Bluffton, SC 29910
Phone (843) 645-8220

75 Baylor Dr
Ste 205
Bluffton, SC 29910
Phone (843) 706-2255

109 Liner Dr
Greenwood, SC 29646
Phone (864) 227-6401

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

25 Hospital Ctr
Ste 300
Hilton Head Island, SC 29926
Phone (843) 681-8203

8 Hospital Center Blvd
Ste 130
Hilton Head Island, SC 29926
Phone (843) 682-2740

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

120 Akers Farm Rd
Christiansburg, VA 24073
Phone (540) 382-3440

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: egwynn192575@selfregional.direct-ci.net
  • Direct secure messaging: egwynn9726@direct.carilionclinic.org
  • Direct secure messaging: eric.gwynn.1@16436.direct.athenahealth.com
  • Direct secure messaging: eric.gwynn.1@30548.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0fba742b-eec1-4103-87e5-edbdf1fe1e30/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Novant Health Coastal Carolina Medical CenterHardeeville, SC, CCN 420101 Hospital Corporate Director Jan 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1467586628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BAYLOR DR STE 205",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108965",
            "telephone_number": "843-706-2255",
            "fax_number": "843-706-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BAYLOR DR STE 205",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108965",
            "telephone_number": "843-706-2255",
            "fax_number": "843-706-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYNN",
        "first_name": "ERIC",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "110158",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "35373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF8401",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.