Spartanburg Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPARTANBURG MEDICAL CENTER

Practice address

444 NC Highway 108
Rutherfordton, NC 28139-7871

Phone

(828) 286-2302

Fax

(828) 287-4320

NPI assigned

Sep 6, 2006

Organization subpart

Yes

Parent organization

SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INCAs reported in NPPES

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

Authorized official

Name

Kenneth Meinke

Title

Chief Financial Officer

Phone

(864) 560-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medical Group of the Carolinas - Family Medicine - Rutherfordton Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Spartanburg Medical Center

  • Family Medicine Physician
  • Columbus, NC
  • NPI 1043528201

  O20040513000988

  Same enrollment
• Spartanburg Medical Center

  • Cardiovascular Disease Physician
  • Columbus, NC
  • NPI 1548652027

  O20040513000988

  Same enrollment
• Spartanburg Medical Center

  • Family Medicine Physician
  • Forest City, NC
  • NPI 1568400174

  O20040513000988

  Same enrollment

Part of

Spartanburg Regional Health Services District Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roberta Jennings, NP

  • Family Nurse Practitioner
  • Spartanburg, SC
  • NPI 1942271622
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1831292788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4057",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 NC HIGHWAY 108",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281397871",
            "telephone_number": "828-286-2302",
            "fax_number": "828-287-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC",
        "enumeration_date": "2006-09-06",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "MEINKE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "864-560-6000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN1627",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904764",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Group of the Carolinas - Family Medicine - Rutherfordton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Group of the Carolinas - Family Medicine - Rutherfordton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Robert George Stallings, M.D.
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• Miranda Clara Starnes, COTA/L
• Drew John Steiner, MD
• Michael Brian Taub, LCMHC

• Family Medicine Physician in Rutherfordton, NC
• Providers in Rutherfordton, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.