Individual provider Active NPI

Earl Clinton Wood IV, M.D.

  • Radiation Oncology Physician
  • Greenwood, SC
National Provider Identifier
1962524314
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
34015 Issued in SC
Practice address
1325 Spring St
Greenwood, SC 29646-3860
Phone
(864) 725-7100
Fax
(864) 725-7101
NPI assigned
Apr 5, 2007
Sex
Male
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 34015 SC Primary

Addresses

Primary practice location

1325 Spring St
Greenwood, SC 29646-3860

Mailing address

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-7100

Other identifiers 1

IdentifierTypeStateIssuer
340152MedicaidSC

Other names 1

  • Clint Wood Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwood188628@selfregional.direct-ci.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111018000353 SC Practitioner - Radiation Oncology 8820260839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Kentucky College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4272

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34015SCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Aug 1, 2011 Accepting new patients
Self Medical Group Current Accepting new patients
Self Medical Group CurrentSince Aug 1, 2011 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

104 Wells Ave
Greenwood, SC 29646

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

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

298 Commerce Dr
Newberry, SC 29108
Phone (803) 321-3232

Interoperability endpoints

  • Direct secure messaging: cwood188628@selfregional.direct-ci.net
  • Direct secure messaging: clint.wood@selfregional.direct.varian.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1962524314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-7100",
            "fax_number": "864-725-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-7100",
            "fax_number": "864-725-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "EARL",
        "middle_name": "CLINTON",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "34015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340152",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwood188628@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "1325 Spring St",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CLINT",
            "last_name": "WOOD",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.