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Self Regional Healthcare Partners

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Edgefield, SC

NPI 1780168971 · NPPES record last updated Dec 14, 2021

Key facts

NPI
1780168971
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
Legal business name
SELF REGIONAL HEALTHCARE PARTNERS
Practice address
300 Ridge Medical Plaza Rd
Edgefield, SC 29824-4525
Phone
(803) 637-3174
Fax
(803) 637-0200
NPI assigned
Sep 24, 2018
Organization subpart
No

Authorized official

Name
Dr. Matthew T Logan, MD
Title
President and Ceo
Phone
(864) 725-4253

Owners & managing parties with NPI records 17

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

Other NPIs on the same Medicare enrollment 4

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

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

Affiliated clinicians 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SC

Hospital certification: CCN 42Z304

Legal name
SELF REGIONAL HEALTHCARE PARTNERS
Organization structure
Other · Proprietary
Enrollment address
300 Ridge Medical Plaza Rd
Edgefield, SC 29824-4525
Other Hospital Practice Location

All disclosed owners & managing parties 4

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 Officer
President		 Dec 21, 2021
Self Regional Healthcare
Organization · Greenwood, SC
Created for acquisition, Non-profit, Chain home office 		5% Or Greater Direct Ownership Interest Jan 1, 2019 100%
William F Gordon
Individual 		Corporate Director Oct 1, 2024
W-2 Managing Employee Oct 1, 2024
Clint J Stewart
Individual 		Corporate Director Oct 21, 2024
W-2 Managing Employee Oct 21, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190129003656 SC Part B Supplier - Clinic/Group Practice 1557606118 Receives reassigned benefits from 133 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edgefield, SC; Johnston, SC
O20220916001251 SC Part a Provider - Critical Access Hospital 1557606118 Practice locations: Edgefield, SC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Yes

Addresses

Primary practice location

300 Ridge Medical Plaza Rd
Edgefield, SC 29824-4525

Mailing address

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

Other names

  • ECH Swing Bed, An Affiliate of Self Regional Healthcare Doing business as

Other providers in Edgefield, SC

All providers in Edgefield, SC · Medicare Defined Swing Bed Hospital Unit in South Carolina

Sources for this page

Verify at the official NPI Registry.