NPIMap

Individual provider Active NPI

Dillard W Stephens, DO

  • Family Medicine Physician
  • Laurens, SC
National Provider Identifier
1902302516
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51929 Issued in SC
Practice address
22580 Highway 76 E Ste 100
Laurens, SC 29360
Phone
(864) 833-5986
Fax
(864) 833-0599
NPI assigned
Apr 3, 2018
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51929 SC Primary

Addresses

Primary practice location

22580 Highway 76 E Ste 100
Laurens, SC 29360

Mailing address

22580 Highway 76 E Ste 100
Laurens, SC 29360-8460
Phone (864) 833-5986

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702000889 SC Practitioner - Family Practice 3577897149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4398

22580 Hwy 76 E
Suite 100
Laurens, SC 29360-8460
Phone (864) 833-5986

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51929SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Self Regional Healthcare CurrentSince Oct 1, 2025 Accepting new patients
Self Regional Healthcare Family Medicine Current Accepting new patients
Self Medical Group CurrentSince Jul 1, 2019 Accepting new patients
Self Medical Group Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Self Medical Group Current Accepting new patients
Self Regional Healthcare Family Medicine Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

102 Rockcreek Blvd
Greenwood, SC 29649
Phone (864) 725-5020

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

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

22580 Highway 76 E
Ste 100
Laurens, SC 29360
Phone 8648335986 ext. 54673

22580 Highway 76 E
Ste 300
Laurens, SC 29360
Phone (864) 939-1070

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

Organizations & group practices 8

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1902302516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E STE 100",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293608460",
            "telephone_number": "864-833-5986",
            "fax_number": "864-833-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22580 HIGHWAY 76 E STE 100",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "29360",
            "telephone_number": "864-833-5986",
            "fax_number": "864-833-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DILLARD",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "51929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurens, SC

Sources for this page

Verify at the official NPI Registry.