SELF MEDICAL GROUP (NPI# 1629382056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629382056 |
| Entity Type | Organization |
| Organization Name | SELF MEDICAL GROUP |
| Other Organization Name | FAMILY HEALTHCARE SAVANNAH LAKES, A DIVISION OF SELF MEDICAL GROUP |
| Practice Address |
207 Holiday Road Mccormick SC 29835-3430 |
| Practice Telephone | 8643915011 |
| Practice Fax Number | 8643915012 |
| Mailing Telephone | 8643915011 |
| Mailing Fax Number | 8643915012 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2016-05-26 |
| Authorized Official Name | JAMES A PFEIFFER (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Telephone | 8647254253 |
| Is Organization Subpart | Y |
| Parent Organization Name | SELF MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Family Healthcare Savannah Lakes, A Division of Self Medical Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487212130 | Self Medical Group | Family Medicine | 105 Vinecrest Ct # 510, Greenwood, SC 29646-8031 | 2019-05-29 |
| 1750800264 | Self Medical Group | Family Medicine | 110 Highway 246 N, Greenwood, SC 29649-8748 | 2017-09-15 |
| 1760808083 | Self Medical Group | Clinic/Center | 450 Old Brickyard Rd, Greenwood, SC 29649-8681 | 2014-03-11 |
| 1588969448 | Self Medical Group | Nurse Practitioner | 104 Liner Drive, Greenwood, SC 29646 | 2011-01-24 |
| 1417252636 | Self Medical Group | Family Medicine | 138 Wells Avenue, Greenwood, SC 29646-3837 | 2011-01-19 |
| 1376843037 | Self Medical Group | Obstetrics & Gynecology | 107 Venture Court, Greenwood, SC 29649-8558 | 2010-10-28 |
| 1942528161 | Self Medical Group | Family Medicine | 167 Greenwood Ave S, Ware Shoals, SC 29692 | 2010-05-12 |
| 1134442890 | Self Medical Group | Physician Assistant | 115 Academy Avenue, Unit A, Greenwood, SC 29646 | 2010-03-10 |
| 1457685570 | Self Medical Group | Surgery | 160 Academy Avenue, Greenwood, SC 29646-3808 | 2009-09-22 |
| 1982836847 | Self Medical Group | Surgery | 1325 Spring Street, Greenwood, SC 29646-3860 | 2009-08-11 |
| Street Address |
207 HOLIDAY ROAD |
| City | MCCORMICK |
| State | SC |
| Zip Code | 29835-3430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528609948 | Tontalia Williams | Technician | 108 Oak Street, Mccormick, SC 29835 | 2019-10-07 |
| 1275095580 | Ohio Valley Physicians Inc | Family Medicine | 504 North Mine St, Mccormick, SC 29835 | 2019-04-04 |
| 1992904536 | Robert Jay Lagroon | Dentist | 791 Hwy 7, Mccormick, SC 29835 | 2007-07-13 |
| 1063545119 | Carolina Health Centers, Inc. | Clinic/Center | 219a North Mine Street, Mccormick, SC 29835 | 2007-03-14 |
| 1336272400 | Carolina Health Centers | Dentist | 219b North Mine Street, Mccormick, SC 29835 | 2007-03-14 |
| 1245329143 | Carrie Gwennette Motes | Counselor | 202 Hwy. 28 North, Mccormick, SC 29835 | 2006-10-11 |
| 1437259207 | Pearl Blair-aiken | Social Worker | 209 Peachtree Street, Mccormick, SC 29835 | 2006-09-22 |
| 1710082391 | Susan Elizabeth Davis | Counselor | 202 Mine Street, Mccormick, SC 29835 | 2006-09-14 |
| 1851308456 | Savannah Heights Living Center, LLC | Skilled Nursing Facility | 1 Holiday Rd, Mccormick, SC 29835 | 2006-08-03 |
| 1134159171 | Robert J Kellett | Family Medicine | 219-a North Mine Street, Mccormick, SC 29835 | 2006-07-04 |
| Find all providers in zip 29835 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275095580 | Ohio Valley Physicians Inc | Family Medicine | 504 North Mine St, Mccormick, SC 29835 | 2019-04-04 |
| 1134159171 | Robert J Kellett | Family Medicine | 219-a North Mine Street, Mccormick, SC 29835 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495841 | Neuro Health Sc LLC | Family Medicine | 108 Commons Blvd Ste A, Piedmont, SC 29673-7766 | 2020-10-21 |
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1154928570 | Lexington Health Inc | Family Medicine | 146 E Hospital Dr Ste 500, West Columbia, SC 29169-4842 | 2020-10-08 |
| 1477150340 | Meghan Hodapp | Family Medicine | 623 Awendaw Lakes Blvd, Awendaw, SC 29429-6407 | 2020-10-05 |
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1851906267 | Avneet Nagra | Family Medicine | 162 Montauk Dr, Lexington, SC 29072-6776 | 2020-09-11 |
| 1134732753 | Ovp Health Care, Inc. | Family Medicine | 101 S Catawba St, Lancaster, SC 29720-2411 | 2020-08-24 |
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1841801149 | Palmetto Primary Care Physicians, LLC | Family Medicine | 1200 Two Island Ct Unit E, Mt Pleasant, SC 29466-7418 | 2020-08-11 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.