NPIMap

Organization Active NPI

Self Regional Healthcare Partners

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

  • Medicare Defined Swing Bed Hospital Unit
  • Edgefield, SC
National Provider Identifier
1780168971
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SELF REGIONAL HEALTHCARE PARTNERS
Doing business as
ECH Swing Bed, An Affiliate of Self Regional Healthcare
Practice address
300 Ridge Medical Plaza Rd
Edgefield, SC 29824-4525
Phone
(803) 637-3174
Fax
(803) 637-0200
NPI assigned
Sep 24, 2018
Last updated
Dec 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Dr. Matthew T Logan, MDNPI 1902868078
Title
President and Ceo
Phone
(864) 725-4253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

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 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780168971. Details of each certification follow.

Hospital certification: CCN 42Z304

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

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Member of 1

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

Locations

155 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3146

Ownership & related parties

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 OfficerPresident 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

Owners & managing parties with NPI records 17

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

View all 17

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1780168971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4111",
            "fax_number": "864-725-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIDGE MEDICAL PLAZA RD",
            "city": "EDGEFIELD",
            "state": "SC",
            "postal_code": "298244525",
            "telephone_number": "803-637-3174",
            "fax_number": "803-637-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF REGIONAL HEALTHCARE PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECH Swing Bed, An Affiliate of Self Regional Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgefield, SC

Sources for this page

Verify at the official NPI Registry.