NPIMap

Organization Active NPI

Spartanburg Medical Center

  • Emergency Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1699729939
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SPARTANBURG MEDICAL CENTER
Practice address
101 E Wood St
Emergency Center
Spartanburg, SC 29303-3040
Phone
(864) 560-7025
Fax
(864) 560-7388
NPI assigned
May 20, 2006
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Bruce A Davis
Title
Chief Financial Officer
Phone
(864) 560-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Emergency Care Clinic/Center 261QE0002X

Addresses

Primary practice location

101 E Wood St
Emergency Center
Spartanburg, SC 29303-3040

Mailing address

PO Box 743070
Atlanta, GA 30384-3070
Phone (864) 560-4304

Other identifiers 6

IdentifierTypeStateIssuer
100OtherSCBCBS SUFFIX
8510OtherSCMEDICARE PIN
20057400OtherSCSELECT HEALTH OF SC
GP4440MedicaidSC
097OtherSCTRICARE SUFFIX
5903906MedicaidNC

Other names 1

  • Medical Group of the Carolinas - Emergency Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702000686 SC Part B Supplier - Clinic/Group Practice 3072425297 Receives reassigned benefits from 808 practitioners
45 other NPIs on this enrollment
Practice locations: Spartanburg, SC; Greer, SC; Travelers Rest, SC; Union, SC; Whitmire, SC; Drayton, SC; Gaffney, SC; Gray Court, SC…

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 45

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

View all 45

National Provider Directory

National Provider Directory
Part of
Spartanburg Regional Health Services District Inc

Locations

1201 Furman L Fendley Hwy
Union, SC 29379
Phone (864) 301-2000

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Spartanburg Medical CenterSpartanburg, SC, CCN 420007 Hospital Operational/Managerial Control Nov 27, 2007
Spartanburg Medical CenterSpartanburg, SC, CCN 42S007 Hospital Operational/Managerial Control Nov 27, 2007
Spartanburg Medical CenterSpartanburg, SC, CCN 42T007 Hospital Operational/Managerial Control Nov 27, 2007
Spartanburg Regional HospiceSpartanburg, SC, CCN 421500 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 1995
May 1, 1995
CMC - Center for OB/GYNGaffney, SC, CCN 423492 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 10, 2021

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners 1,277

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,277

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1699729939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "address_2": "EMERGENCY CENTER",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-7025",
            "fax_number": "864-560-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "864-560-6000"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SUFFIX",
            "identifier": "100",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "8510",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH OF SC",
            "identifier": "20057400",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4440",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SUFFIX",
            "identifier": "097",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903906",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Group of the Carolinas - Emergency Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.