NPIMap

Organization Active NPI

Self Regional Healthcare

Doing business as Pain Management Laurens

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
National Provider Identifier
1720938103
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
SELF REGIONAL HEALTHCARE
Doing business as
Pain Management Laurens
Practice address
23013 Highway 76 E Ste C
Clinton, SC 29325-7530
Phone
(864) 725-4095
NPI assigned
Feb 3, 2026
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

23013 Highway 76 E Ste C
Clinton, SC 29325-7530

Mailing address

1325 Spring St
Greenwood, SC 29646-3875
Phone (864) 725-4673

Other names 1

  • Pain Management Laurens Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051214000767 SC Part B Supplier - Clinic/Group Practice 4082527742 Receives reassigned benefits from 234 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwood, SC; Clinton, SC; Ware Shoals, SC; Saluda, SC; Ninety Six, SC; Newberry, SC; MC Cormick, SC; Laurens, SC…
O20060329000365 SC Part A Provider - Hospital 4082527742 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Cormick, SC; Laurens, SC; Greenwood, SC; Clinton, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720938103. Details of each certification follow.

Hospital certification: CCN 420071

Legal name
SELF REGIONAL HEALTHCARE
Doing business as
SELF REGIONAL HEALTHCARE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 1, 1969
Last certification
Sep 9, 2022
Beds
358
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Enrollment address
1325 Spring St
Greenwood, SC 29646-3860
Main/Primary Hospital Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 29

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

View all 29

Care Compare: Hospital

Medicare Care Compare
Listed as
Self Regional HealthcareCCN 420071 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew T Logan Individual Corporate OfficerPresident and Ceo Dec 21, 2021
W-2 Managing EmployeePresident and Ceo Dec 21, 2021
Self Regional Healthcare Organization, Greenwood, SC Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Sep 30, 2025 100%
Clint J Stewart Individual Corporate OfficerVP & Cfo Oct 21, 2024
W-2 Managing Employee Oct 21, 2024

Owners & managing parties with NPI records 17

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 17

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 601

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 601

NPI Registry JSON

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1720938103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463875",
            "telephone_number": "864-725-4673",
            "fax_number": "864-725-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23013 HIGHWAY 76 E STE C",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257530",
            "telephone_number": "864-725-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "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": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management Laurens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, SC

Sources for this page

Verify at the official NPI Registry.