SPARTANBURG MEDICAL CENTER (NPI# 1689143786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689143786 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG MEDICAL CENTER |
| Other Organization Name | MEDICAL GROUP OF THE CAROLINAS-UROLOGY -SKYLYN |
| Practice Address |
11 Doctors Park Dr Ste 220 Spartanburg SC 29307-1008 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8642538055 |
| Practice Fax Number | 8642538126 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2019-03-13 |
| Authorized Official Name | KENNETH J MEINKE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8645606103 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PIN | 5019 | 01 |
| SC | GP8761 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Group of the Carolinas-Urology -Skylyn | 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 |
11 DOCTORS PARK DR STE 220 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538698030 | Deborah Temples Anderson | Nurse Practitioner | 11 Doctors Park Dr Ste 220, Spartanburg, SC 29307-1008 | 2017-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
| 1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
| 1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
| 1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
| 1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
| 1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
| 1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
| Find all providers in zip 29307 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467893404 | Robert Strehlow Vi | Urology | 391 Serpentine Dr Ste 500, Spartanburg, SC 29303-3083 | 2013-07-06 |
| 1376551713 | Mary Black Health System, LLC | Urology | 1 Doctors Park Dr, Spartanburg, SC 29307-1021 | 2006-08-03 |
| 1598717951 | R Bruce Bass | Urology | 1 Doctors Park Drive, Suite B, Spartanburg, SC 29307-1008 | 2006-05-16 |
| 1821226960 | Erin Anderson | Urology | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3096 | 2009-06-28 |
| 1699711317 | Michael B Pryor | Urology | 391 Serpentine Dr, Suite 200, Spartanburg, SC 29303-3083 | 2006-06-21 |
| 1639130628 | Gerald W Hull IIi | Urology | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3083 | 2006-03-29 |
| 1093775926 | Robert G Britanisky | Urology | 391 Serpentine Dr., Suite500, Spartanburg, SC 29303-3083 | 2006-03-24 |
| 1356317325 | Paul T Ellis | Urology | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3083 | 2006-02-28 |
| 1912903659 | Michael Curtis Staley | Urology | 391 Serpentine Dr, Suite 500, Spartanburg, SC 29303-3096 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295393098 | Christopher William Ritchie | Urology | 135 Rutledge Ave Fl 5, Charleston, SC 29425-8903 | 2019-06-05 |
| 1780248211 | Spartanburg Medical Center | Urology | 2755 S Highway 14 Ste 2050a, Greer, SC 29650-4902 | 2019-04-30 |
| 1609345982 | Spartanburg Medical Center | Urology | 1552 N Limestone St Ste A, Gaffney, SC 29340-4750 | 2018-11-16 |
| 1942775952 | Roper Saint Francis Physicians Network | Urology | 300 Callen Blvd Ste 220, Summerville, SC 29486-2809 | 2018-10-05 |
| 1790131522 | Urology Clinic At Carolinas | Urology | 1594 Freedom Blvd Ste 203, Florence, SC 29505-6046 | 2016-05-11 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| 1154700367 | Gregory Slachta | Urology | 407 Broadview Dr, Ridgeland, SC 29936-5157 | 2015-05-20 |
| 1326487588 | Tracy Jon Tipton | Urology | 125 Doughty St Ste 300, Charleston, SC 29403 | 2013-06-21 |
| 1790121424 | Philip Andre Fontenot Jr. | Urology | 50 Bear Dr, Greenville, SC 29605 | 2013-05-21 |
| 1679828750 | Thomas Alexander Kirkland Jr. | Urology | 2 Ladson St, Apt. A, Charleston, SC 29401-2757 | 2012-07-16 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
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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.