SPARTANBURG REGIONAL MED CTR (NPI# 1164536074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164536074 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG REGIONAL MED CTR |
| Other Organization Name | MAGNOLIA CENTER FOR PLASTIC SURGERY VILLAGE OF PELHAM |
| Practice Address |
2755 S Highway 14 Suite 1200l Greer SC 29650-4902 |
| Mailing Address |
Po Box 2168 Spartanburg SC 29304 |
| Practice Telephone | 8648499330 |
| Practice Fax Number | 8645604413 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2009-04-23 |
| Authorized Official Name | GINA MICHELLE HILLERS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8645604057 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4480 | 05 | |
| SC | RAILROAD MEDICARE GROUP # | CN1627 | 01 |
| Other Name | Type Code |
|---|---|
| Magnolia Center for Plastic Surgery Village of Pelham | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710918230 | Spartanburg Regional Med Ctr | Psychiatry & Neurology | 853 N Church Street, Suite 640, Spartanburg, SC 29303-3040 | 2006-07-05 |
| 1710922703 | Spartanburg Regional Med Ctr | Pediatrics | 3941 Hwy 9, Ste B, Boiling Springs, SC 29316 | 2006-06-17 |
| 1023392883 | Spartanburg Regional Med Ctr | Pediatrics | 853 N Church St, Suite 401, Spartanburg, SC 29303-3098 | 2011-09-28 |
| 1700176054 | Spartanburg Regional Med Ctr | Plastic Surgery | 29 Rocky Slope Rd, Greenville, SC 29607-3909 | 2011-04-07 |
| 1588998629 | Spartanburg Regional Med Ctr | Internal Medicine | 322 Memorial Dr, Greer, SC 29650-1521 | 2009-09-22 |
| 1417281650 | Spartanburg Regional Med Ctr | Internal Medicine | 325 Medical Pkwy, Suite 200, Greer, SC 29650-2457 | 2009-09-21 |
| 1922243674 | Spartanburg Regional Med Ctr | Obstetrics & Gynecology | 373 Halton Rd, Greenville, SC 29607-3405 | 2008-12-10 |
| 1497900641 | Spartanburg Regional Med Ctr | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2008-12-01 |
| 1568616076 | Spartanburg Regional Med Ctr | Internal Medicine | 1702 Skylyn Dr, Unit C, Spartanburg, SC 29307-1040 | 2008-11-11 |
| 1730376948 | Spartanburg Regional Med Ctr | Obstetrics & Gynecology | 1686 Skylyn Dr, Suite 102, Spartanburg, SC 29307-1058 | 2007-10-02 |
| Street Address |
2755 S HIGHWAY 14 SUITE 1200L |
| City | GREER |
| State | SC |
| Zip Code | 29650-4902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538164546 | Surgery Center At Pelham, LLC | Clinic/Center | 2755 S Highway 14, Greer, SC 29650-4926 | 2005-06-16 |
| 1598111353 | Spartanburg Medical Center | Nurse Practitioner | 2755 S Highway 14, Suite 2200, Greer, SC 29650-4902 | 2016-05-11 |
| 1972963494 | Spartanburg Medical Center | Physical Medicine & Rehabilitation | 2755 S Highway 14, Suite 1450, Greer, SC 29650-4902 | 2016-02-25 |
| 1245608934 | Spartanburg Medical Center | Dermatology | 2755 S Highway 14, Suite 2050, Greer, SC 29650-4902 | 2015-09-11 |
| 1114302767 | Spartanburg Medical Center | Family Medicine | 2755 S Highway 14, Suite 1200f, Greer, SC 29650-4902 | 2015-07-24 |
| 1720470206 | Spartanburg Medical Center | Allergy & Immunology | 2755 S Highway 14, Suite 1200h, Greer, SC 29650-4902 | 2015-02-20 |
| 1174940498 | Spartanburg Medical Center | Internal Medicine | 2755 S Highway 14, Suite 2500, Greer, SC 29650-4941 | 2014-03-25 |
| 1366703845 | James Baker Romine | Physician Assistant | 2755 S Highway 14, Ste 1200l, Greer, SC 29650-4902 | 2012-05-31 |
| 1659692952 | John Albert Lucas Iv | Family Medicine | 2755 S Highway 14, Suite 1200l, Greer, SC 29650-4902 | 2010-06-21 |
| 1902124050 | Jenna Elise Rolfs | Physician Assistant | 2755 S Highway 14, Suite 2200, Greer, SC 29650-4902 | 2010-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154946424 | Paul Wong | Family Medicine | 109 Physicians Drive Suite A, Greer, SC 29650 | 2020-06-12 |
| 1992273684 | Christopher Michael Campbell | Pharmacist | 845b S Buncombe Rd, Greer, SC 29650 | 2018-11-12 |
| 1376035618 | Jessica Miller | Dentist | 1494 W Wade Hampton Blvd Ste D, Greer, SC 29650 | 2018-06-02 |
| 1992212872 | Greenville Health Corporation | Pharmacy | 845 S Buncombe Rd Ste D, Greer, SC 29650 | 2018-01-02 |
| 1114432077 | Spartanburg Medical Center | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200m, Greer, SC 29650 | 2017-12-13 |
| 1437679750 | Sanders Healthcare LLC | Home Health | 110 W. Church St., Suite A, Greer, SC 29650 | 2017-06-27 |
| 1306291117 | James Elliott Crouch | Occupational Therapy Assistant | 1305 Boilings Springs Rd., Greer, SC 29650 | 2016-04-29 |
| 1033593389 | Premier Medical Transport Service | Non-emergency Medical Transport (VAN) | 120 Glenaire Dr, Greer, SC 29650 | 2015-07-16 |
| 1104176429 | Suchi Chomal | Pharmacist | 6 Colby Ct, Greer, SC 29650 | 2012-09-13 |
| 1447500822 | John Varner | Pharmacist | 821 S. Batesville Road, Greer, SC 29650 | 2012-09-13 |
| Find all providers in zip 29650 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083900724 | Kevin Shultz | Surgery | 301 The Pkwy, Greer, SC 29650-5221 | 2011-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796150 | Lexington Health Inc | Surgery | 2728 Sunset Blvd Ste 105, West Columbia, SC 29169-4839 | 2020-10-09 |
| 1407472251 | Paulina Bao Tran Le | Surgery | Prisma Health Medical Group Plastic Surgery, 2 Medical Park, Ste 302, Columbia, SC 29203 | 2020-06-17 |
| 1366788580 | John Jacob Keyser | Surgery | 4094 Spring Is, Okatie, SC 29909-4053 | 2012-12-15 |
| 1780971135 | Paul Diegidio | Surgery | 1721 Ebenezer Rd Ste 115, Rock Hill, SC 29732-1119 | 2011-07-06 |
| 1184757288 | Ted R Vaughn | Surgery | 305a W Alexander Ave, Greenwood, SC 29646-4009 | 2007-03-14 |
| 1568535847 | Griffin Plastic Surgery PC | Surgery | 513 S Dargan St, Florence, SC 29506-2549 | 2006-11-16 |
| 1881786820 | Kimberley B Goh | Surgery | 4610 Oleander Drive, 101, Myrtle Beach, SC 29577 | 2006-09-28 |
| 1780797449 | Marcelo L. Hochman | Surgery | 2097 Henry Techlenburg Dr, Suite 212 West, Charleston, SC 29416-5739 | 2006-08-16 |
| 1750304333 | Patrick O'neill | Surgery | 245 Seven Farms Dr, Suite 210, Daniel Island, SC 29492-8500 | 2006-07-25 |
| 1659325371 | Steven K White | Surgery | 1275 21st Ave N, Myrtle Beach, SC 29577-7429 | 2006-05-19 |
| 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.