SELF MEDICAL GROUP (NPI# 1376843037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376843037 |
| Entity Type | Organization |
| Organization Name | SELF MEDICAL GROUP |
| Other Organization Name | WOMEN'S ADVANCED CARE GREENWOOD, A DIVISION OF SELF MEDICAL GROUP |
| Practice Address |
107 Venture Court Greenwood SC 29649-8558 |
| Practice Telephone | 8645386565 |
| Practice Fax Number | 8645386566 |
| Mailing Telephone | 8645386565 |
| Mailing Fax Number | 8645386566 |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2012-05-23 |
| Authorized Official Name | JAMES A PFEIFFER (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| 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 | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Women's Advanced Care Greenwood, A Division of Self Medical Group | 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 |
| 1760808083 | Self Medical Group | Clinic/Center | 450 Old Brickyard Rd, Greenwood, SC 29649-8681 | 2014-03-11 |
| 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 |
| 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 |
107 VENTURE COURT |
| City | GREENWOOD |
| State | SC |
| Zip Code | 29649-8558 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609124494 | Martin Thomas Feeney | Obstetrics & Gynecology | 4094 Rockingchair Rd, Greenwood, IN 46142-8360 | 2012-08-27 |
| 1982786745 | Ems Clinic | Obstetrics & Gynecology | 1509 Strong Ave, Greenwood, MS 38930 | 2006-10-20 |
| 1073695839 | Greenwood Clinic for Women Pllc | Obstetrics & Gynecology | 1604 Leflore Ave, Greenwood, MS 38930 | 2006-10-20 |
| 1619925294 | John Andrew Haws Russell | Obstetrics & Gynecology | 106 Liner Dr, Greenwood, SC 29646 | 2006-05-05 |
| 1154386019 | John Gary Eichelberger | Obstetrics & Gynecology | 106 Liner Drive, Greenwood, SC 29646 | 2006-04-20 |
| 1871562231 | Rana Skaf | Obstetrics & Gynecology | 203 9th St, Greenwood, MS 38930-4015 | 2006-03-16 |
| 1053311001 | Tessa M Asdell | Obstetrics & Gynecology | 533 E County Line Rd, Suite 102, Greenwood, IN 46143-1048 | 2005-07-29 |
| 1730182064 | Michael Bruce Gentry | Obstetrics & Gynecology | 107 Venture Ct, Greenwood, SC 29649-8558 | 2005-05-31 |
| 1912900051 | Debra Larkins | Obstetrics & Gynecology | 333 E County Line Rd, Suite B, Greenwood, IN 46143-1046 | 2005-05-23 |
| 1346697992 | Jenna Rae Voirol | Obstetrics & Gynecology | 533 E County Line Rd Ste 102, Greenwood, IN 46143-1074 | 2016-05-24 |
| Find all providers in GREENWOOD | ||||
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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.