Newberry County Memorial Hospital
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Newberry, SC
NPI 1730468992 · NPPES record last updated Aug 5, 2011
Key facts
- NPI
- 1730468992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- HTL-015 (SC)
- Legal business name
- NEWBERRY COUNTY MEMORIAL HOSPITAL
- Practice address
- 2669 Kinard St
Newberry, SC 29108-2911 - Phone
- (803) 405-7537
- Fax
- (803) 405-7196
- NPI assigned
- Aug 5, 2011
- Organization subpart
- No
Authorized official
- Name
- Ms. Rhonda Williams
- Title
- PFS Manager
- Phone
- (803) 405-7537
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 12
Related certifications (CCN) 1
Practitioners 16
-
Tamara S Baker, APRN, FNP-C
-
Gregory E Barefoot, P.A.C.
-
Mark A Davis, MD
-
Sherard T. Houston, M.D.
-
Kendell Cantrell Mature, PA-C
-
Sean O'Meara, MD
-
Michael Todd O'Neil, D.O.
-
Stephen W Orville, M.D.
-
Ravikumar K Patel, D.O.
-
Nicholas Kent Petrus, PA-C
-
Casey Hendrix Purcell, NP-C
-
Brian W. Weaver, MD
-
Laurel Susan Stacey, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Hospital certification: CCN 42U053
- Legal name
- NEWBERRY COUNTY MEMORIAL HOSPITAL
- Organization structure
- Government · Non-profit
- Incorporated
- in SC
- Enrollment address
- 2669 Kinard Street
Newberry, SC 29108-0497 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| John Snow |
W-2 Managing Employee |
Apr 24, 2023 | |
| Gena a Driggers |
W-2 Managing Employee |
May 1, 2017 | |
| John Pugh |
Other | Jul 21, 2015 | |
| John Doyle |
W-2 Managing Employee |
Sep 19, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100910000099 | SC | Part a Provider - Hospital | 8123927464 |
1 other NPI on this enrollment Practice locations: Newberry, SC |
National Provider Directory
- Tax ID family
- David L Oliver MD
Locations
2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | HTL-015 | SC | Yes |
Addresses
Primary practice location
2669 Kinard St
Newberry, SC 29108-2911
Mailing address
2669 Kinard St
Newberry, SC 29108-2911
Phone (803) 405-7537
Other providers in Newberry, SC
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
- Newberry County Memorial Hospital
All providers in Newberry, SC · Medicare Defined Swing Bed Hospital Unit in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.