NPIMap

Organization Active NPI

Newberry County Memorial Hospital

Doing business as Newberry Health Primary Care and Pediatrics

  • Family Medicine Physician
  • Newberry, SC
National Provider Identifier
1962213785
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEWBERRY COUNTY MEMORIAL HOSPITAL
Doing business as
Newberry Health Primary Care and Pediatrics
Practice address
2605 Kinard St Ste 208
Newberry, SC 29108-2966
Phone
(803) 945-4202
Fax
(803) 945-4238
NPI assigned
Jan 20, 2025
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
John Walter PughNPI 1265613376
Title
Board Member
Phone
(803) 364-2310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

2605 Kinard St Ste 208
Newberry, SC 29108-2966

Mailing address

2605 Kinard St Ste 208
Newberry, SC 29108-2966
Phone (803) 945-4202

Other names 1

  • Newberry Health Primary Care and Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000264 SC Part B Supplier - Clinic/Group Practice 8123927464 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Mountain, SC; Whitmire, SC; Newberry, SC

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2320523Newberry Health Primary Care and Pediatrics2605 Kinard St, Newberry, SC 29108Certificate of waiverMar 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Newberry Cnty Memorial Hosp13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1240 Hunt St
Newberry, SC 29108
Phone (803) 276-3577

1830 Pondfield Rd
Ste A1
Newberry, SC 29108
Phone (803) 405-7140

1830 Pondfield Rd
Ste A3
Newberry, SC 29108
Phone (803) 405-7140

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1962213785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KINARD ST STE 208",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082966",
            "telephone_number": "803-945-4202",
            "fax_number": "803-945-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KINARD ST STE 208",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082966",
            "telephone_number": "803-945-4202",
            "fax_number": "803-945-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "803-364-2310"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newberry Health Primary Care and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newberry, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.