NPIMap

Organization Active NPI

Spartanburg Medical Center

Doing business as Medical Group of the Carolinas - Hematology Oncology - Laurens

  • Hematology & Oncology Physician
  • Clinton, SC
National Provider Identifier
1649424151
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
SPARTANBURG MEDICAL CENTER
Doing business as
Medical Group of the Carolinas - Hematology Oncology - Laurens
Practice address
22725 Highway 76 E
Outpatient Center, Third Floor
Clinton, SC 29325-7527
Phone
(864) 938-0620
Fax
(864) 938-9830
NPI assigned
Nov 11, 2008
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Kenneth Meinke
Title
Chief Financial Officer
Phone
(864) 560-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

22725 Highway 76 E
Outpatient Center, Third Floor
Clinton, SC 29325-7527

Mailing address

380 Serpentine Dr
Suite 200
Spartanburg, SC 29303-3066
Phone (864) 560-7050

Other identifiers 1

IdentifierTypeStateIssuer
GP4991MedicaidSC

Other names 1

  • Medical Group of the Carolinas - Hematology Oncology - Laurens Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000129 SC Part B Supplier - Clinic/Group Practice 3072425297 Receives reassigned benefits from 806 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spartanburg, SC; Union, SC; Boiling Springs, SC; Lyman, SC; Greer, SC; Greenville, SC; Gaffney, SC; Duncan, SC…

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

National Provider Directory

National Provider Directory
Tax ID family
Wellford Family Medicine136 organizations share this tax ID, including this one
Part of
Spartanburg Regional Health Services District Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

22725 Highway 76 E
Fl Third
Clinton, SC 29325
Phone (864) 938-0620

NPI Registry JSON

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1649424151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SERPENTINE DR",
            "address_2": "SUITE 200",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033066",
            "telephone_number": "864-560-7050",
            "fax_number": "864-560-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22725 HIGHWAY 76 E",
            "address_2": "OUTPATIENT CENTER, THIRD FLOOR",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257527",
            "telephone_number": "864-938-0620",
            "fax_number": "864-938-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC",
        "enumeration_date": "2008-11-11",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "MEINKE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "864-560-6000"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4991",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Group of the Carolinas - Hematology Oncology - Laurens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.