NPIMap

Organization Active NPI

Self Medical Group

  • Neonatal-Perinatal Medicine Physician
  • Greenwood, SC
National Provider Identifier
1871816538
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
SELF MEDICAL GROUP
Practice address
1325 Spring Street
Greenwood, SC 29646-3860
Phone
(864) 725-4449
Fax
(864) 725-4452
NPI assigned
Mar 10, 2010
Last updated
Dec 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Dr. Matthew T Logan, MD
Title
President and Chief Executive Offic
Phone
(864) 725-4253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X Primary

Addresses

Primary practice location

1325 Spring Street
Greenwood, SC 29646-3860

Mailing address

1325 Spring Street
Greenwood, SC 29646-3860
Phone (864) 725-4449

Other names 1

  • Neonatology Specialists of Self Medical Group Other name

National Provider Directory

National Provider Directory
Tax ID family
Self Medical Group25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1871816538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING STREET",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4449",
            "fax_number": "864-725-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SPRING STREET",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-4449",
            "fax_number": "864-725-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE OFFIC",
        "authorized_official_telephone_number": "864-725-4253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neonatology Specialists of Self Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Neonatology Specialists of Self Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.