Individual provider Active NPI

Michael Josiah Maughon Jr., M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Greenwood, SC
National Provider Identifier
1629003751
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
29150 Issued in SC
Practice address
102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone
(864) 229-2663
Fax
(864) 223-5694
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 29150 SC
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 29150 SC Primary

Addresses

Primary practice location

102 Gregor Mendel Cir
Greenwood, SC 29646-2315

Mailing address

102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone (864) 229-2663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmaughon53639@selfregional.direct-ci.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906002060 SC Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 0446428742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Medical University of South Carolina College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone (864) 229-2663

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Abbeville Area Medical Center Hospital, Abbeville, SC, CCN 421301

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)11
Upper limb (arm) arthroscopy (minimally invasive joint repair)20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29150SCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group Orthopaedic Surgery CurrentSince Oct 1, 2016 Accepting new patients
Self Medical Group CurrentSince Oct 1, 2016 Accepting new patients
Self Regional Healthcare CurrentSince Dec 20, 2016 Accepting new patients
Self Medical Group Current Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

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

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

102 Gregor Mendel Cir
Greenwood, SC 29646
Phone (864) 229-2663

22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480

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

Interoperability endpoints

  • Direct secure messaging: mmaughon53639@selfregional.direct-ci.net

Organizations & group practices 7

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

Hospital & facility affiliations 6

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1629003751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462315",
            "telephone_number": "864-229-2663",
            "fax_number": "864-223-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462315",
            "telephone_number": "864-229-2663",
            "fax_number": "864-223-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUGHON",
        "first_name": "MICHAEL",
        "middle_name": "JOSIAH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "29150",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": "29150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaughon53639@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "102 Gregor Mendel Cir",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296462315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.