SELF MEDICAL GROUP


Address: 450 Old Brickyard Rd, Greenwood, SC 29649-8681
Phone: 8647257491

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QX0100X Clinic/Center
Specialization: Occupational Medicine
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Light and Life Wellness Clinic Other Name - Individual/Organization

Other Provider IDs and Locations

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

Office Location

Street Address 450 OLD BRICKYARD RD
City GREENWOOD
State SC
Zip Code 29649-8681

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QX0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Occupational Medicine

Taxonomy Definition

Definition to come...

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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

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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
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Competitor

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City GREENWOOD
Zip Code 29649

Improve Information

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Dataset Information

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.

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