Spartanburg Regional Med Ctr
Organization Active NPI Internal Medicine Physician · Greer, SC
NPI 1679504187 · NPPES record last updated Oct 25, 2007
Key facts
- NPI
- 1679504187
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- SPARTANBURG REGIONAL MED CTR
- Practice address
- 2755 South Highway 14
Suite 1200I
Greer, SC 29650-4902 - Phone
- (864) 849-9190
- Fax
- (864) 560-4413
- NPI assigned
- Jul 5, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
- Name
- Gina Michelle Hillers
- Title
- Credentialing Specialist
- Phone
- (864) 560-4057
Other NPIs on the same Medicare enrollment 45
Corporate family (same tax ID) 24
Practitioners 10
-
Kelsey Baizan, PA, RD
-
Erin Heidi Herring, CRNA
-
Tameka Roman Irvin, FNP
-
Shannon S. Jones, CRNA
-
Debra Miller-Cox, M.D.
-
Martha Ann Raines, N.P.
-
Megan C. Souther, NP
-
Ronak Patel, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040702000686 | SC | Part B Supplier - Clinic/Group Practice | 3072425297 |
Receives reassigned benefits from 808 practitioners 45 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spartanburg, SC; Greer, SC; Travelers Rest, SC; Union, SC; Whitmire, SC; Drayton, SC; Gaffney, SC; Gray Court, SC… |
National Provider Directory
- Tax ID family
- SRMC Subacute Care Phys
- Part of
- Spartanburg Regional Health Services District Inc
Locations
2755 S Highway 14
Ste 1200I
Greer, SC 29650
Phone (864) 849-9190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
2755 South Highway 14
Suite 1200I
Greer, SC 29650-4902
Mailing address
PO Box 2168
Spartanburg, SC 29304
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN1627 | Other | SC | RAILROAD MEDICARE GROUP# |
| GP4493 | Medicaid | SC | |
| GP1118 | Medicaid | SC |
Other names
- SPARTANBURG INTERNAL MEDICINE AT VILLAGE OF PELHAM
Other providers in Greer, SC
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Med Ctr
- Spartanburg Regional Medical Ctr
- Sports Spine & Industrial, Inc.
- Juhi Srivastava
All providers in Greer, SC · Internal 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 Oct 25, 2007. 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.