SPARTANBURG MEDICAL CENTER (NPI# 1861961963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861961963 |
| Entity Type | Organization |
| Organization Name | SPARTANBURG MEDICAL CENTER |
| Other Organization Name | MEDICAL GROUP OF THE CAROLINAS- DIVISION OF SURGERY -SKYLYN |
| Practice Address |
1690 Skylyn Dr Ste 350 Spartanburg SC 29307-1039 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645771600 |
| Practice Fax Number | 8642787085 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2020-08-03 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PIN | 7628 | 01 |
| SC | GP8760 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Group of the Carolinas- Division of Surgery -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 |
1690 SKYLYN DR STE 350 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1346710407 | Spartanburg Medical Center | Internal Medicine | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2018-12-03 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073136511 | Trey Jeffrey Mathews | Surgery | 101 E. Wood St, Spartanburg, SC 29303-3098 | 2020-05-19 |
| 1548526783 | William Charles Elston | Surgery | 339 Fairlane Dr, Spartanburg, SC 29307-3840 | 2012-04-02 |
| 1043441736 | Michael G Mount | Surgery | 853 N Church St Ste 500, Spartanburg, SC 29303-3077 | 2009-07-29 |
| 1477508877 | Sylvia S Tarazi | Surgery | 385 Serpentine Dr, Spartanburg, SC 29303-3018 | 2006-05-23 |
| 1306803200 | Ernest Camp IIi | Surgery | 16 Drayton Ct, Spartanburg, SC 29301-6519 | 2006-04-26 |
| 1457316978 | Christope Liem Nguyen | Surgery | 101 E Wood St Fl 3, Spartanburg, SC 29303 | 2006-04-18 |
| 1386607349 | Richard Bennett Reinhardt Jr. | Surgery | 1330 Boiling Springs Rd Ste 2300, Spartanburg, SC 29303 | 2006-04-10 |
| 1659332815 | James D Dunn | Surgery | 324 N Pine St, Spartanburg, SC 29302-1631 | 2006-03-29 |
| 1144297888 | Auburn Woods IIi | Surgery | 1330 Boiling Springs Road, Suite 2300, Spartanburg, SC 29303 | 2006-03-01 |
| 1275505026 | Mark O Smith | Surgery | 1650 Skylyn Dr Ste 240, Spartanburg, SC 29307-1069 | 2006-02-06 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
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.