NPIMap

Organization Active NPI

Abbeville County Memorial Hospital

Doing business as Due West Family Medicine

  • Adult Medicine Physician
  • Due West, SC
National Provider Identifier
1689048464
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
ABBEVILLE COUNTY MEMORIAL HOSPITAL
Doing business as
Due West Family Medicine
Practice address
6 College St
Due West, SC 29639-9554
Phone
(864) 379-2345
Fax
(864) 379-3228
NPI assigned
Nov 17, 2015
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ABBEVILLE COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Matthew Tolbert LoganNPI 1902868078
Title
President & Ceo
Phone
(864) 725-4780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary
Diabetology (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QD0401X
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X

Addresses

Primary practice location

6 College St
Due West, SC 29639-9554

Mailing address

PO Box 75833
Chicago, IL 60675-5833
Phone (864) 366-5011

Other names 1

  • Due West Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000214 SC Part B Supplier - Clinic/Group Practice 7719891506 Receives reassigned benefits from 102 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Abbeville, SC; Due West, SC

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
J E Todd M Gonzalez MD2 organizations share this tax ID, including this one
Part of
J E Todd M Gonzalez MD

Other organizations with this tax ID 1

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

Locations

102 Trinity St
Abbeville, SC 29620

104 W Pickens St
Abbeville, SC 29620
Phone (864) 366-3395

763 Highway 28 Byp
Ste 16
Abbeville, SC 29620
Phone (864) 366-0222

763 Highway 28 Byp
Ste 17
Abbeville, SC 29620
Phone (864) 366-9151

901 W Greenwood St
#8A
Abbeville, SC 29620
Phone (864) 366-6060

901 W Greenwood St
#8B
Abbeville, SC 29620
Phone (864) 366-5345

901 W Greenwood St
Ste 3
Abbeville, SC 29620
Phone (864) 366-0647

901 W Greenwood St
Ste 4
Abbeville, SC 29620
Phone (864) 366-0647

901 W Greenwood St
Ste 7
Abbeville, SC 29620
Phone 8643664565 ext. 1723

6 College St
Due West, SC 29639
Phone (864) 379-2345

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 102

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1689048464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75833",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606755833",
            "telephone_number": "864-366-5011",
            "fax_number": "864-366-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COLLEGE ST",
            "city": "DUE WEST",
            "state": "SC",
            "postal_code": "296399554",
            "telephone_number": "864-379-2345",
            "fax_number": "864-379-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBEVILLE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABBEVILLE COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2015-11-17",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TOLBERT",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "864-725-4780"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QD0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Diabetology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Due West Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Due West Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Due West, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.