NPIMap

Organization Active NPI

Self Regional Healthcare

Doing business as Academy Medical Clinic

  • Multi-Specialty Clinic/Center
  • Greenwood, SC
National Provider Identifier
1619240777
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SELF REGIONAL HEALTHCARE
Doing business as
Academy Medical Clinic
Practice address
155 Academy Ave
Greenwood, SC 29646-3869
Phone
(864) 725-4865
NPI assigned
Feb 20, 2012
Last updated
Mar 14, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SELF REGIONAL HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Authorized official

Name
James Pfeiffer
Title
President and Ceo
Phone
(864) 725-4253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

155 Academy Ave
Greenwood, SC 29646-3869

Mailing address

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

Other names 1

  • Academy Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lawrence B Beasley MD49 organizations share this tax ID, including this one
Part of
Lawrence B Beasley MD

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1619240777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF REGIONAL HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELF REGIONAL HEALTHCARE",
        "enumeration_date": "2012-02-20",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "PFEIFFER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "864-725-4253"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academy Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.