Self Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SELF MEDICAL GROUP

Practice address

22580 Highway 76 E
Suite 100
Laurens, SC 29360-8439

Phone

(864) 833-5986

Fax

(864) 833-0599

NPI assigned

Oct 25, 2012

Last updated

Dec 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew T Logan, MD

Title

President and Ceo

Phone

(864) 725-4253

Specialties & licenses 1

Addresses

Other names 1

• Family Healthcare Clinton Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 2

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.

• Christopher C Knox

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1699864702
  NPD
• Randall Lee Nord, PA

  • Surgical Physician Assistant
  • Alabaster, AL
  • NPI 1326195173
  NPD

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1730432873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E",
            "address_2": "SUITE 100",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293608439",
            "telephone_number": "864-833-5986",
            "fax_number": "864-833-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E",
            "address_2": "SUITE 100",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293608439",
            "telephone_number": "864-833-5986",
            "fax_number": "864-833-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "864-725-4253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare Clinton",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Family Healthcare Clinton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Scbma (Martha Franks Baptist Retirement Center)
• Jenna Michelle Schreiner, PA-C
• Self Medical Group
• Self Medical Group (Clinton Family Medicine)
• Self Medical Group
• Self Regional Healthcare (Self Medical Center Laurens)
• Self Regional Healthcare (Self Medical Center Laurens)
• Self Regional Physician Services (The Family Healthcare Center)
• Ruth S Shealy, NP
• Stephanie Elaine Shealy, MSP, CCC-SLP

• Family Medicine Physician in Laurens, SC
• Providers in Laurens, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.