SELF MEDICAL GROUP (NPI# 1760808083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760808083 |
Entity Type | Organization |
Organization Name | SELF MEDICAL GROUP |
Other Organization Name | LIGHT AND LIFE WELLNESS CLINIC |
Practice Address |
450 Old Brickyard Rd Greenwood SC 29649-8681 |
Mailing Address |
104 Wells Ave Greenwood SC 29646-3837 |
Practice Telephone | 8647257491 |
Mailing Telephone | 8647257491 |
Enumeration Date | 2014-03-11 |
Last Update Date | 2014-03-11 |
Authorized Official Name | JAMES PFEIFFER (PRESIDENT AND CEO) |
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 | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Light and Life Wellness Clinic | 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 |
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 |
1629382056 | Self Medical Group | Family Medicine | 207 Holiday Road, Mccormick, SC 29835-3430 | 2010-07-27 |
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 |
450 OLD BRICKYARD RD |
City | GREENWOOD |
State | SC |
Zip Code | 29649-8681 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346895455 | Prathamkumar Rakeshkumar Patel | Pharmacist | 508 By-pass 72 Northwest, Greenwood, SC 29649 | 2019-08-06 |
1821650284 | Lindsay Kay Fuqua | Dentist | 1302 Sc-72 Business, Greenwood, SC 29649 | 2019-07-05 |
1457830291 | Stephanie Dixon | Speech-Language Pathologist | 1075 Bypass 25 Ne, Greenwood, SC 29649 | 2018-08-13 |
1891286613 | Tylan Creek Family Dentistry Greenwood | Clinic/Center | 3710 Highway 221- 72e, Greenwood, SC 29649 | 2018-05-29 |
1225549090 | Tekola Moore | Registered Nurse | 150 By-pass 225, Greenwood, SC 29649 | 2017-10-19 |
1629588520 | Adrienne Jackson | Prosthetist | 2005 Old Laurens Rd, Greenwood, SC 29649 | 2017-10-05 |
1982141115 | Debras Hair Studio LLC | Prosthetic/Orthotic Supplier | 1516 Bypass 72 Ne Ste D, Greenwood, SC 29649 | 2017-01-25 |
1225406960 | Jim Nasim | Dentist | 101 West Durst Avenue, Greenwood, SC 29649 | 2015-09-11 |
1174905806 | Social Change Initiative | Case Management | 1402 C Hwy 72 West, Greenwood, SC 29649 | 2015-06-18 |
1346661683 | Cambridge Dental of Greenwood, LLC | Clinic/Center | 1302 Sc Hwy 72 W Business, Greenwood, SC 29649 | 2014-01-03 |
Find all providers in zip 29649 |
Taxonomy Code | 261QX0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Occupational Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346572823 | Community Rehab Services South Park | Clinic/Center | 98 S Park Blvd, Greenwood, IN 46143-8836 | 2010-02-08 |
1730401910 | Occupational Health Greenwood | Clinic/Center | 1664 W Smith Valley Rd, Greenwood, IN 46142-1550 | 2010-02-16 |
1033441522 | Medcheck Greenwood | Clinic/Center | 1664 W Smith Valley Rd, Greenwood, IN 46142-1550 | 2010-02-08 |
1336471812 | Community Rehab Services Library Park | Clinic/Center | 637 S State Road 135, Suite C, Greenwood, IN 46142-1443 | 2010-02-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336576610 | Healthworks Med Group of South Carolina P C | Clinic/Center | 3704 Louis Rich Rd, Newberry, SC 29108-1413 | 2013-10-02 |
1063846913 | Healthworks Med Group of South Carolina, P C | Clinic/Center | 10 Bib Way, Anderson, SC 29626-6047 | 2013-08-28 |
1356374128 | Lexington County Health Services District, Inc. | Clinic/Center | 3799 12th Street Ext Ste 110, Cayce, SC 29033-3750 | 2006-07-07 |
1700839610 | Vital Energy Occ Therapy & Wellness Ctr LLC | Clinic/Center | 1812 Augusta Hwy, Ste L, Lexington, SC 29072 | 2006-05-19 |
1558969808 | Lexington Health Inc | Clinic/Center | 3799 12th Street Ext Ste 110, Cayce, SC 29033-3750 | 2020-10-09 |
1104389592 | Occuaptional Health Centers of The Southwest, P.a. | Clinic/Center | 4600 Goer Dr Ste 205, North Charleston, SC 29406-6536 | 2019-04-11 |
1285197699 | Cerner Health Connections, Inc | Clinic/Center | 4374 Lancaster Hwy, Richburg, SC 29729-9060 | 2019-04-11 |
1013324128 | Midlands Exams and Drug Screening, Inc | Clinic/Center | 3020 Sunset Blvd, Suite 102, West Columbia, SC 29169-3493 | 2014-07-21 |
1144577743 | Healthworks Med Group of South Carolina P C | Clinic/Center | 415 Brockman Mcclimon Rd, Greer, SC 29651-6608 | 2012-08-14 |
1740579382 | Aoh Occupational Health, LLC | Clinic/Center | 3625 W Montague Ave, N Charleston, SC 29418-5942 | 2011-04-05 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on SELF MEDICAL GROUP.
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.