Individual provider Active NPI

Bibb Randall Cain, MD

  • Emergency Medicine Physician
  • Greenwood, SC
National Provider Identifier
1780602771
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13300 Issued in SC
Practice address
1325 Spring St
Greenwood, SC 29646-3860
Phone
(864) 725-4799
Fax
(864) 725-4707
NPI assigned
Jul 17, 2006
Last updated
May 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13300 SC Primary

Addresses

Primary practice location

1325 Spring St
Greenwood, SC 29646-3860

Mailing address

6 Keystone Cir
Abbeville, SC 29620-5265
Phone (864) 223-2500

Other identifiers 1

IdentifierTypeStateIssuer
133000MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000477 SC Practitioner - Emergency Medicine 7810914538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13300SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group Current Accepting new patients
Self Medical Group CurrentSince Feb 3, 2018 Accepting new patients
Self Medical Group CurrentSince Feb 3, 2018 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6875
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: bcain61633@selfregional.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1780602771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 KEYSTONE CIR",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205265",
            "telephone_number": "864-223-2500",
            "fax_number": "864-725-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4799",
            "fax_number": "864-725-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "BIBB",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "13300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133000",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.