Self Regional Healthcare
Organization Active NPI Family Medicine Physician · Newberry, SC
NPI 1548068398 · NPPES record last updated Jul 17, 2025
Key facts
- NPI
- 1548068398
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SELF REGIONAL HEALTHCARE
- Practice address
- 2605 Kinard St Ste 200a
Newberry, SC 29108-2965 - Phone
- (803) 405-1900
- Fax
- (803) 405-1919
- NPI assigned
- Mar 6, 2025
- Organization subpart
- No
Authorized official
- Name
- Matthew Tolbert Logan
- Title
- President & Ceo
- Phone
- (864) 725-4780
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 46
Member organizations 17
Practitioners 152
-
Ashleigh Wilson Leopard, APRN
-
Casey Long, PA-C
-
Joshua Walker, PA-C
-
Matthew Adams, MD
-
Christa Armfield Anderson, DNP, FNP-C
-
Juliana Atkins, MD
-
Alan Baker, APRN FNP-C
-
Karl Ekkehard Boellert Jr., M.D., M.P.H.
-
Ryan Joseph Bolt, DO
-
Andrea Branyon, APRN, FNP-BC
-
Rodrine Asante Buffaloe, M.D.
-
Samuel T Burnett III, M.D.
-
Theresa Calderon, DNP APRN FNP-C
-
Rachel L Case, NP
-
Chelsea R. Castellone, PA-C
-
Samuel L Clarke, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051214000767 | SC | Part B Supplier - Clinic/Group Practice | 4082527742 |
Receives reassigned benefits from 234 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Greenwood, SC; Clinton, SC; Ware Shoals, SC; Saluda, SC; Ninety Six, SC; Newberry, SC; MC Cormick, SC; Laurens, SC… |
National Provider Directory
- Tax ID family
- Western Carolina Psych
Locations
909 W Greenwood St
Abbeville, SC 29620
115 Academy Ave
Greenwood, SC 29646
Phone (864) 725-7272
155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865
114 Gtwy Corp Blvd 220
Greenwood, SC 29647
2605 Kinard St
Ste 200A
Newberry, SC 29108
Phone (803) 405-1900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Urology Physician |
208800000X |
Addresses
Primary practice location
2605 Kinard St Ste 200a
Newberry, SC 29108-2965
Mailing address
104 Wells Ave
Greenwood, SC 29646-3837
Phone (864) 725-4673
Other names
- Self Medical Center Newberry
Other providers in Newberry, SC
- Kenneth Norman Sawyer III
- SC Department of Juvenile Justice
- School District of Newberry County
- Self Medical Group
- Self Regional Healthcare
- Margaret Dorroh Senn
- Joel S. Sexton
- Melanie H Shealy
- Tyronza Nicole Sheppard
- Rajendra Shrestha
All providers in Newberry, SC · Family Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.