SPARTANBURG MEDICAL CENTER (NPI# 1861851446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861851446 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG MEDICAL CENTER |
| Other Organization Name | MEDICAL GROUP OF THE CAROLINAS- IMMEDIATE CARE CENTER-PELHAM |
| Practice Address |
3611 Pelham Rd Greenville SC 29615-5002 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645603500 |
| Practice Fax Number | 8645603525 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | KENNETH MEINKE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8645606000 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
SC | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP7221 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Group of the Carolinas- Immediate Care Center-Pelham | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386205094 | Spartanburg Medical Center | Pediatrics | 575 Ingles Dr Ste A, Inman, SC 29349-8314 | 2019-06-24 |
| 1780248211 | Spartanburg Medical Center | Urology | 2755 S Highway 14 Ste 2050a, Greer, SC 29650-4902 | 2019-04-30 |
| 1205499217 | Spartanburg Medical Center | Internal Medicine | 104 Professional Park Ste C, Gaffney, SC 29340-2319 | 2019-04-16 |
| 1649735127 | Spartanburg Medical Center | Family Medicine | 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 | 2019-02-08 |
| 1316416415 | Spartanburg Medical Center | Orthopaedic Surgery | 1650 Skylyn Dr Ste 120, Spartanburg, SC 29307-1069 | 2018-11-19 |
| 1609345982 | Spartanburg Medical Center | Urology | 1552 N Limestone St Ste A, Gaffney, SC 29340-4750 | 2018-11-16 |
| 1316416688 | Spartanburg Medical Center | Internal Medicine | 104 Professional Park Ste B, Gaffney, SC 29340-2319 | 2018-11-16 |
| 1396220554 | Spartanburg Medical Center | Surgery | 840 W Floyd Baker Blvd Ste B, Gaffney, SC 29341-1845 | 2018-10-03 |
| 1114432077 | Spartanburg Medical Center | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200m, Greer, SC 29650 | 2017-12-13 |
| 1518498336 | Spartanburg Medical Center | Family Medicine | 2846 N Old Laurens Rd, Gray Court, SC 29645-3157 | 2017-03-23 |
| Street Address |
3611 PELHAM RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29615-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013932359 | Richard W. Vail | Internal Medicine | 3611 Pelham Rd, Greenville, SC 29615-5002 | 2006-07-13 |
| 1881075570 | Jordan Blake Adams | Family Medicine | 3611 Pelham Rd, Greenville, SC 29615-5002 | 2015-06-18 |
| 1073741500 | Chad Anthony Leep | Family Medicine | 3611 Pelham Rd, Greenville, SC 29615-5002 | 2009-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
| 1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
| 1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
| 1255816070 | Trevis L Cureton | Pharmacist | 2401 East North St, Greenville, SC 29615 | 2018-09-27 |
| 1497232565 | Jacob J Fountain | Nurse Practitioner | 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 | 2018-07-23 |
| 1346726924 | St. Francis Physician Services, Inc | Internal Medicine | 5 Hoke Smith Blvd, Greenville, SC 29615 | 2018-07-17 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1316466543 | Mariah Hope Mosher | Behavioral Analyst | 7 Mckenna Commons Court, Greenvilee, SC 29615 | 2017-09-19 |
| 1326400896 | Karen L Heaps | Counselor | 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 | 2016-03-24 |
| 1134589013 | Sharon Erk | Technician, Other | 2950 E.norths St, Greenville, OH 29615 | 2016-03-04 |
| Find all providers in zip 29615 | ||||
| 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 |
|---|---|---|---|---|
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1457983280 | Emmyget Family Medicine, Pa | Family Medicine | 3405 White Horse Rd Ste E, Greenville, SC 29611-5947 | 2020-02-10 |
| 1275184848 | Rmcca Clinic B, LLC | Family Medicine | 45 Medical Arts Ct Ste 3, Greenville, AL 36037-3872 | 2019-09-25 |
| 1558918342 | Lv Stabler Primary Care LLC | Family Medicine | 45 Medical Arts Ct Ste 2, Greenville, AL 36037-3872 | 2019-08-26 |
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1336618222 | Ashley Rushin | Family Medicine | 4400 Interstate Highway 30 W, Greenville, TX 75402-4615 | 2018-11-20 |
| 1003209636 | Billy Don Mitchell | Family Medicine | 3080 Cr 3115, Billy Don Mitchell M.d., Greenville, TX 75402 | 2015-03-06 |
| 1437597259 | Frank V Cioppettini | Family Medicine | 31 Memorial Medical Dr, Greenville, SC 29605-4407 | 2013-06-14 |
| 1679816706 | St. Francis Physician Services Inc | Family Medicine | 75 E. Mcbee Avenue, Greenville, SC 29601-2737 | 2013-03-27 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29615 |
Please comment or provide details below to improve the information on SPARTANBURG MEDICAL CENTER.
| 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.