INTERNAL MEDICAL LAURENS A DIVISION OF SELF MEDICAL GROUP
NPI 1104137892
Internal Medicine in Laurens, SC
About Internal Medical Laurens A Division Of Self Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTERNAL MEDICAL LAURENS A DIVISION OF SELF MEDICAL GROUP (NPI 1104137892) is a healthcare organization registered as an internal medicine in Laurens, South Carolina and active in the NPI registry since June 2010. The organization lists Matthew T Logan, President And Chief Executive Offic, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Internal Medical Laurens A Division Of Self Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
560Medicare enrollment records show 560 clinicians reassign Medicare billing to Internal Medical Laurens A Division Of Self Medical Group, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 13 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 43
Nearest to this location (20)
See all 560Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D0950983
Internal Medicine Laurens A Division Of Self Medical Group · Laurens, SCFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Self Medical Group's NPI number?
The NPI number for Self Medical Group is 1104137892. It was assigned to this organization in the NPPES registry on June 28, 2010. The provider is also known as Internal Medical Laurens A Division Of Self Medical Group.
Where is Self Medical Group located?
Self Medical Group is located at 22580 Highway 76 E Suite 200, Laurens, SC 29360. The listed phone number is (864) 833-0055.
What is Self Medical Group's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Self Medical Group enrolled in Medicare?
Yes. Self Medical Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Self Medical Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 560 clinicians in 43 Medicare specialties reassign their Medicare billing to Self Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (95), Nurse Practitioner (87) and Emergency Medicine (59). Of these, 11 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Self Medical Group accept?
Health plans from BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Self Medical Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Self Medical Group was last updated on December 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Internal Medical Laurens A Division Of Self Medical Group · NPI 1104137892
Internal Medicine organization in Laurens, South Carolina. Organization record, active in the CMS NPPES registry since June 28, 2010.
## Identity
- **NPI:** 1104137892 (Entity type: Organization)
- **Enumerated:** June 28, 2010
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Self Medical Group
- **Organization subpart:** No
- **Authorized official:** Matthew Logan, PRESIDENT AND CHIEF EXECUTIVE OFFIC
## Practice location
- **Address:** 22580 HIGHWAY 76 E, SUITE 200, Laurens, SC 29360-8439
- **Phone:** (864) 833-0055 · **Fax:** (864) 833-4008
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 560 clinicians in 43 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (95), Nurse Practitioner (87), Emergency Medicine (59); 11 practice at this address and 13 within 10 miles; [full list](https://npiprofile.com/npi/1104137892/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 14, 2021
- **Other identifiers:** Medicaid GP5453 (SC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104137892) · Data from the CMS NPPES public registry.