NPIMap

Organization Active NPI

Spartanburg Regional Healthcare System

  • Geriatric Medicine (Family Medicine) Physician
  • Spartanburg, SC
National Provider Identifier
1750352332
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
22026 Issued in SC
Legal business name
SPARTANBURG REGIONAL HEALTHCARE SYSTEM
Practice address
120 Heywood Ave
Spartanburg, SC 29302-1210
Phone
(864) 560-3860
Fax
(864) 560-3712
NPI assigned
Jan 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward Warren, MD
Title
Physician
Phone
(864) 560-3860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X 22026 SC Primary

Addresses

Primary practice location

120 Heywood Ave
Spartanburg, SC 29302-1210

Mailing address

120 Heywood Ave
Spartanburg, SC 29302-1210
Phone (864) 560-3860

Other identifiers 1

IdentifierTypeStateIssuer
T62508MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
SRMC Subacute Care Phys136 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750352332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEYWOOD AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021210",
            "telephone_number": "864-560-3860",
            "fax_number": "864-560-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEYWOOD AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021210",
            "telephone_number": "864-560-3860",
            "fax_number": "864-560-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG REGIONAL HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "864-560-3860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "22026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T62508",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.