NPIMap

Organization Active NPI

Cherokee Medical Center

Doing business as CMC-Immediate Care Center-Gaffney

  • Rural Health Clinic/Center
  • Gaffney, SC
National Provider Identifier
1902447022
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHEROKEE MEDICAL CENTER
Doing business as
CMC-Immediate Care Center-Gaffney
Practice address
840 W Floyd Baker Blvd
Gaffney, SC 29341-1845
Phone
(864) 489-3300
Fax
(864) 488-3744
NPI assigned
Sep 30, 2019
Last updated
Sep 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

840 W Floyd Baker Blvd
Gaffney, SC 29341-1845

Mailing address

PO Box 277723
Atlanta, GA 30384-7723
Phone (864) 560-6000

Other identifiers 2

IdentifierTypeStateIssuer
RHC246MedicaidSC
42-3472OtherSCMEDICARE PIN

Other names 1

  • CMC-Immediate Care Center-Gaffney Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191111002373 SC Part A Provider - Rural Health Clinic 5991041212 Practice locations: Gaffney, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902447022. Details of each certification follow.

Rural health clinic certification: CCN 423472

Legal name
CHEROKEE MEDICAL CENTER
Doing business as
CMC - IMMEDIATE CARE CENTER - GAFFNEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 11, 2020
Last certification
Mar 11, 2020
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
840 W Floyd Baker Blvd
Gaffney, SC 29341-1845
Related CCNs
420043

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Cherokee Medical Center11 organizations share this tax ID, including this one
Part of
Spartanburg Regional Health Services District Inc

Other organizations with this tax ID 10

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Apella Health Management Inc Organization, Spartanburg, SC Non-profit Operational/Managerial Control Jan 1, 2019
Elmer B Holstien Individual Corporate OfficerCeo Oct 1, 2019
W-2 Managing EmployeeCeo Oct 1, 2019
Operational/Managerial ControlCeo Oct 1, 2019
Spartanburg Regional Health Services District Inc Organization, Spartanburg, SC 5% Or Greater Direct Ownership Interest Oct 1, 2019 100%
Operational/Managerial Control Oct 1, 2019 100%
Charles E Morrow Individual Corporate OfficerCoo-Medical Group/Post Acute Divisi Dec 4, 2023
W-2 Managing EmployeeCoo-Medical Group/Post Acute Divisi Dec 4, 2023
Bruce a Davis Individual Corporate OfficerCfo-Spartanburg Regional Health Jan 25, 2020
W-2 Managing EmployeeCfo-Spartanburg Regional Health Jan 25, 2020
Operational/Managerial ControlCfo-Spartanburg Regional Health Jan 25, 2020

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1902447022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847723",
            "telephone_number": "864-560-6000",
            "fax_number": "864-560-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W FLOYD BAKER BLVD",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293411845",
            "telephone_number": "864-489-3300",
            "fax_number": "864-488-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.",
        "enumeration_date": "2019-09-30",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "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": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC246",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "42-3472",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC-Immediate Care Center-Gaffney",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMC-Immediate Care Center-Gaffney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.