NPIMap

Organization Active NPI

Newberry County Memorial Hospital

  • General Acute Care Hospital
  • Newberry, SC
National Provider Identifier
1710073739
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HTL-015 Issued in SC
Legal business name
NEWBERRY COUNTY MEMORIAL HOSPITAL
Practice address
2669 Kinard St
Newberry, SC 29108-2911
Phone
(803) 276-7570
NPI assigned
Oct 5, 2006
Last updated
Dec 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Authorized official

Name
Michael L Reynolds
Title
Chief Financial Officer
Phone
(803) 405-7469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HTL-015 SC Primary

Addresses

Primary practice location

2669 Kinard St
Newberry, SC 29108-2911

Mailing address

2669 Kinard St
Newberry, SC 29108-2911

Other identifiers 1

IdentifierTypeStateIssuer
400532MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040106000163 SC Part B Supplier - Clinic/Group Practice 8123927464 Receives reassigned benefits from 12 practitioners
Practice locations: Newberry, SC

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Newberry Cnty Memorial Hosp13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1710073739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 KINARD ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 KINARD ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082911",
            "telephone_number": "803-276-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-405-7469"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400532",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.