SPARTANBURG MEDICAL CENTER (NPI# 1003900143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003900143 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG MEDICAL CENTER |
| Other Organization Name | MEDICAL GROUP OF THE CAROLINAS - FAMILY MEDICINE - CONVERSE HEIGHTS |
| Practice Address |
120 Heywood Ave Suite 200 Spartanburg SC 29302-1210 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645739595 |
| Practice Fax Number | 8645853752 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-12-09 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1118 | 05 | |
| NC | 89014EG | 05 | |
| SC | GP5638 | 05 | |
| SC | RAILROAD MEDICARE GROUP # | CN1627 | 01 |
| Other Name | Type Code |
|---|---|
| Medical Group of the Carolinas - Family Medicine - Converse Heights | 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 |
120 HEYWOOD AVE SUITE 200 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302-1210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184694168 | Scott A Coley | Family Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-01-24 |
| 1164865473 | Janessa M. Perez-motlis | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2013-04-17 |
| 1316293947 | Jamie Lynn Kilcoyne | Nurse Practitioner | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2012-08-01 |
| 1306000948 | Vincent C Slater | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302 | 2008-07-14 |
| 1356476584 | Spartanburg Regional Healthcare District | Durable Medical Equipment & Medical Supplies | 120 Heywood Ave, Suite 400, Spartanburg, SC 29302-1210 | 2007-02-21 |
| 1558381541 | Spartanburg Medical Center | Home Health | 120 Heywood Ave, Suite 300, Spartanburg, SC 29302-1210 | 2006-07-20 |
| 1942241781 | Spartanburg Regional Med Ctr | Family Medicine | 120 Heywood Ave, Suite 200, Spartanburg, SC 29302-1210 | 2006-06-10 |
| 1851332696 | Spartanburg Regional Med Ctr | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2006-06-10 |
| 1194779017 | Philip A Mahoney Jr. | Family Medicine | 120 Heywood Ave, Spartanburg, SC 29302-1210 | 2006-05-22 |
| 1356393680 | George Liston Bass | Internal Medicine | 120 Heywood Ave, Ste 200, Spartanburg, SC 29302-1210 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| 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 |
|---|---|---|---|---|
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1538713813 | Proactive Md Sc,p.a. | Family Medicine | 101 W Saint John St Ste 107, Spartanburg, SC 29306-5157 | 2019-07-25 |
| 1073171336 | Proactive Md Sc,p.a. | Family Medicine | 801 Union St, Spartanburg, SC 29302-2734 | 2019-06-03 |
| 1841757192 | Paladina Health, LLC | Family Medicine | Paladina Health Smith Drug, 9098 Fairforest Road, Spartanburg, SC 29301 | 2019-02-22 |
| 1487111738 | Paladina Health, LLC | Family Medicine | Paladina Health Spartanburg Palmetto Bank, 101 West Saint John Street Suite 107, Spartanburg, SC 29306 | 2019-02-22 |
| 1649735127 | Spartanburg Medical Center | Family Medicine | 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 | 2019-02-08 |
| 1114403342 | Piedmont Care, Inc. | Family Medicine | 101 N Pine St Ste 200, Spartanburg, SC 29302-1604 | 2018-07-11 |
| 1356871933 | Kristy Kaye Atkinson | Family Medicine | 853 N Church St # 150, Spartanburg, SC 29303-3098 | 2017-06-15 |
| 1003352261 | Academic Primary Care Associates | Family Medicine | 410 Magnolia St, Spartanburg, SC 29303-3640 | 2017-01-12 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
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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.