Tommy Scott Whitehead, PA
Individual provider Active NPI Physician Assistant · Greenwood, SC
NPI 1780770545 · NPPES record last updated Mar 20, 2025
Key facts
- NPI
- 1780770545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 728 (SC)
- Practice address
- 516 Montague Ave
Greenwood, SC 29649-1942 - Phone
- (864) 223-1468
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 39
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Self Medical Group
Self Regional Healthcare Partners
Self Regional Healthcare
Abbeville County Memorial Hospital
Practice addresses (Care Compare)
102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone (864) 229-2663
1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111
155 Ridge Medical Plaza Rd
Edgefield, SC 29824-4531
Phone (803) 637-3146
160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090
22580 Hwy 76 E
Suite 100
Laurens, SC 29360-8460
Phone (864) 833-5986
420 Thomson Cir
Abbeville, SC 29620-5656
Phone (864) 366-1649
901 W Greenwood St
Suite 1
Abbeville, SC 29620-5727
Phone (864) 366-9681
PO Box
Suite 887
Abbeville, SC 29620
Hospital & facility affiliations
- Self Regional Healthcare
- Edgefield County Healthcare an Affiliate of Self R
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050113000592 | SC | Practitioner - Physician Assistant | 5193774412 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Health Centers, Inc. | Current |
Accepting new patients | |
| Self Medical Group | Current |
Accepting new patients | |
| Carolina Health Centers, Inc. | Current |
Accepting new patients | |
| Self Regional Healthcare | Current | Accepting new patients | |
| Abbeville County Memorial Hospital | Current |
Accepting new patients | |
| Self Medical Group | Current |
Accepting new patients | |
| Self Regional Healthcare Partners | Current |
Accepting new patients | |
| Self Regional Healthcare Partners | Current |
Accepting new patients | |
| Abbeville County Memorial Hospital | Current |
Accepting new patients | |
| Self Regional Healthcare | Current |
Accepting new patients | |
| Self Medical Group | Past |
Accepting new patients | |
| Self Regional Healthcare | Past | Accepting new patients | |
| Emergency Physician Services | Past | Accepting new patients | |
| Abbeville County Memorial Hospital | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 1363
Chicago, IL 60675
75 Remittance Dr
Dept 6875
Chicago, IL 60675
75 Remittance Dr
Dept 6793
Chicago, IL 60675
75 Remittance Dr
Dept 6764
Chicago, IL 60675
901 W Greenwood St
Abbeville, SC 29620
Phone (864) 459-5011
420 Thomson Cir
Abbeville, SC 29620
Phone (864) 366-1649
22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100
300 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3174
102 Gregor Mendel Cir
Greenwood, SC 29646
Phone (864) 229-2663
313 Main St
#B
Greenwood, SC 29646
115 Academy Ave
Greenwood, SC 29646
Phone (864) 725-7272
1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111
155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865
104 Wells Ave
Greenwood, SC 29646
22580 Highway 76 E
Ste 100
Laurens, SC 29360
Phone 8648335986 ext. 54673
22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480
207 Holiday Rd
Mc Cormick, SC 29835
Phone (800) 922-4194
2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866
2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570
102 R L Sawyer Md Dr
Saluda, SC 29138
Phone (864) 445-2173
93 S Greenwood Ave
Ware Shoals, SC 29692
Phone (864) 456-7436
Interoperability endpoints
- twhitehead83891@selfregional.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 728 | SC | Yes |
Addresses
Primary practice location
516 Montague Ave
Greenwood, SC 29649-1942
Mailing address
PO Box 749306
Atlanta, GA 30374-9306
Other practice location 1
102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone (864) 229-2663
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057PA | Medicaid | SC | |
| AA76245684 | Other | SC | MEDICARE |
Other providers in Greenwood, SC
- Cheryl Denise White
- Emma Louise White
- Graceann Danielle White
- Michael Jay White
- Stephanie R White
- Lauren R Whitfield
- Rebecca Anne Whittington
- Whole Life Dental
- Whole Life on-Site LLC
- Nancy Hart Wicker
All providers in Greenwood, SC · Physician Assistant 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 20, 2025. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.