Spartanburg Medical Center
Organization Active NPI Obstetrics & Gynecology Physician · Gaffney, SC
NPI 1780924100 · NPPES record last updated Dec 9, 2014
Key facts
- NPI
- 1780924100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- SPARTANBURG MEDICAL CENTER
- Practice address
- 139 Medical Center Dr
Gaffney, SC 29340-4823 - Phone
- (864) 487-7186
- Fax
- (864) 487-7246
- NPI assigned
- Feb 21, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG HEALTH SERVICES, INC
Authorized official
- Name
- Mr. Kenneth Meinke
- Title
- Chief Financial Officer
- Phone
- (864) 560-6000
Other NPIs on the same Medicare enrollment 48
Corporate family (same tax ID) 24
Practitioners 11
-
Amber Bartkowiak, FNP-C
-
Dean Eldon Davis, M.D.
-
Ashley Raye Fowler, M.D.
-
Bang N Giep, M.D.
-
Hoang N Giep, M.D.
-
Carol A Ketchen, MD
-
Aaron M Toler, MD
-
Kimberly F Toler, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040108000827 | SC | Part B Supplier - Clinic/Group Practice | 3072425297 |
Receives reassigned benefits from 324 practitioners 48 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spartanburg, SC; Union, SC; Simpsonville, SC; Boiling Springs, SC; Gaffney, SC; Greenville, SC; Greer, SC |
National Provider Directory
- Tax ID family
- SRMC Subacute Care Phys
- Part of
- Spartanburg Regional Health Services District Inc
Locations
250 North Grove Medical Park Dr
Spartanburg, SC 29303
Phone (864) 208-2345
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | SC | Yes |
Addresses
Primary practice location
139 Medical Center Dr
Gaffney, SC 29340-4823
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP6141 | Medicaid | SC |
Other names
- Medical Group of Carolinas OBGYN-Gaffney
Other providers in Gaffney, 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
- Jada Spencer
- Jessica Sperling
All providers in Gaffney, SC · Obstetrics & Gynecology 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 Dec 9, 2014. 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.