Spartanburg Medical Center
Organization Active NPI Urology Physician · Greer, SC
NPI 1780248211 · NPPES record last updated Jun 26, 2019
Key facts
- NPI
- 1780248211
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- SPARTANBURG MEDICAL CENTER
- Practice address
- 2755 S Highway 14 Ste 2050a
Greer, SC 29650-4902 - Phone
- (864) 253-8055
- Fax
- (864) 253-8126
- NPI assigned
- Apr 30, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Authorized official
- Name
- Kenneth J Meinke
- Title
- Chief Financial Officer
- Phone
- (864) 560-6103
Other NPIs on the same Medicare enrollment 45
Corporate family (same tax ID) 24
Practitioners 5
-
Lauren Inman, NP
-
Adam Marcus Sebasi, M.D.
-
Nalin K Srivastava, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040702000686 | SC | Part B Supplier - Clinic/Group Practice | 3072425297 |
Receives reassigned benefits from 808 practitioners 45 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spartanburg, SC; Greer, SC; Travelers Rest, SC; Union, SC; Whitmire, SC; Drayton, SC; Gaffney, SC; Gray Court, SC… |
National Provider Directory
- Tax ID family
- SRMC Subacute Care Phys
- Part of
- Spartanburg Regional Health Services District Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
2755 S Highway 14 Ste 2050a
Greer, SC 29650-4902
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP9009 | Medicaid | SC | |
| 5019 | Other | SC | MEDICARE PIN |
Other names
- Medical Group of the Carolinas - Urology - Pelham
Other providers in Greer, SC
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Medical Center
- Spartanburg Regional Health Services District, Inc.
- Spartanburg Regional Med Ctr
All providers in Greer, SC · Urology Physician 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 Jun 26, 2019. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.