Cherokee Medical Center
Organization Active NPI Rural Health Clinic/Center · Gaffney, SC
NPI 1760023980 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1760023980
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CHEROKEE MEDICAL CENTER
- Practice address
- 1506 N Limestone St Ste C
Gaffney, SC 29340-4747 - Phone
- (864) 487-4573
- Fax
- (864) 488-0966
- NPI assigned
- Sep 30, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Authorized official
- Name
- Kenneth Meinke
- Title
- Chief Financial Officer
- Phone
- (864) 560-6000
Owners & managing parties with NPI records 17
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 10
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 17
Practitioners 38
-
Susan Kay Bland, MD
-
Michael S Dale, M.D.
-
Sherri E Franks, M.D.
-
Carrie Keenan Hall, FNP-C, APRN
-
Baolam Ho, DO
-
Joshua Holmes, MD
-
Alyssa Sherrill Jackson, DNP, APRN, FNP-BC
-
Howard W Klickman, M.D.
-
Troy D. McCurry, APRN
-
James David McDermott, M.D.
-
Donald T Morgan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Rural health clinic certification: CCN 423492
- Legal name
- CHEROKEE MEDICAL CENTER
- Doing business as
- CMC - CENTER FOR OB/GYN
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 4, 2021
- Last certification
- Nov 4, 2021
- Ownership / control type
- 2B
- Organization structure
- Other · Non-profit
- Enrollment address
- 1506 N Limestone St
Ste C
Gaffney, SC 29340-4747 - Related CCNs
- 420043
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Spartanburg Medical Center |
5% Or Greater Direct Ownership Interest | Jun 10, 2021 | 100% |
| Cody N Butts |
Corporate Officer |
Jun 10, 2021 | |
| W-2 Managing Employee |
Jun 10, 2021 | ||
| Operational/Managerial Control |
Jun 10, 2021 | ||
| Apella Health Management Inc |
Operational/Managerial Control | Jun 10, 2021 | |
| Mark a Aycock |
Contracted Managing Employee |
Jun 10, 2021 | |
| Corporate Officer |
Jun 10, 2021 | ||
| Operational/Managerial Control |
Jun 10, 2021 | ||
| Elmer B Holstien |
Contracted Managing Employee |
Jun 10, 2021 | |
| Corporate Officer |
Jun 10, 2021 | ||
| Operational/Managerial Control |
Jun 10, 2021 | ||
| Kenneth J Meinke |
Contracted Managing Employee |
Jun 10, 2021 | |
| Corporate Officer |
Jun 10, 2021 | ||
| Operational/Managerial Control |
Jun 10, 2021 | ||
| Bruce a Davis |
Corporate Officer |
Jun 10, 2021 | |
| W-2 Managing Employee |
Jun 10, 2021 | ||
| Operational/Managerial Control |
Jun 10, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210723000993 | SC | Part a Provider - Rural Health Clinic | 5991041212 | Practice locations: Gaffney, SC |
National Provider Directory
- Tax ID family
- Cherokee Medical Center
- Part of
- Spartanburg Regional Health Services District Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1506 N Limestone St Ste C
Gaffney, SC 29340-4747
Mailing address
PO Box 277723
Atlanta, GA 30384-7723
Phone (864) 560-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42-3492 | Other | SC | MEDICARE PIN |
| RHC270 | Medicaid | SC |
Other names
- CMC-Center for Ob/Gyn
Other providers in Gaffney, SC
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Medical Center
- Cherokee Pediatric Associates, LLC
All providers in Gaffney, SC · Rural Health Clinic/Center 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 Mar 23, 2022. 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.