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INTERNAL MEDICAL LAURENS A DIVISION OF SELF MEDICAL GROUP
NPI 1104137892
Internal Medicine in Laurens, SC

Active since June 28, 2010CLIA 42D0950983 · Microscopy
22580 HIGHWAY 76 E, SUITE 200, LAURENS, SC 29360(864) 833-0055(864) 833-4008 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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 holds a CLIA Microscopy certificate valid through September 9, 2026 and lists Matthew T Logan, President And Chief Executive Offic, as its authorized official.

NPPES Registry Identity

NPI1104137892
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSELF MEDICAL GROUP
Location Address22580 HIGHWAY 76 E, SUITE 200Laurens, SC 29360-8439
Mailing Address22580 Highway 76 E, Suite 200Laurens, SC 29360-8439 · (864) 833-0055 · Fax (864) 833-4008
Phone(864) 833-0055
Fax(864) 833-4008
Organization SubpartNo
Authorized OfficialMatthew T LoganPresident And Chief Executive Offic · (864) 725-4253
Enumeration DateJune 28, 2010
Last NPPES UpdateDecember 14, 2021
NPPES CertifiedDecember 14, 2021
✔ NPI 1104137892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
22580 HIGHWAY 76 E, Laurens, SC 29360
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Other Names 1

Other NameInternal Medical Laurens A Division Of Self Medical Group

Other Identifiers 1

MedicaidGP5453SC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

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, SC
Active · expires Sep 9, 2026
CLIA Number42D0950983
Laboratory TypePhysician Office
Certificate Effective DateSeptember 10, 2024
Certificate Expiration DateSeptember 9, 2026
Laboratory DirectorBrian Weirick
Laboratory Phone(864) 833-0055
Laboratory LocationInternal Medicine Laurens A Division Of Self Medical Group22580 Hwy 76 East Suite 200, Laurens, SC 29360
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SELF REGIONAL HEALTHCARE
Family Medicine
22580 HIGHWAY 76 E
LAURENS, SC 29360
Laurens County (864) 833-5986
LOUIS M STEPHENS MD
Family Medicine
22580 HIGHWAY 76 E, SUITE 100
LAURENS, SC 29360
Laurens County (864) 833-5986
SELF MEDICAL GROUP
Clinic/Center (Urgent Care)
22580 HIGHWAY 76 E, SUITE 300
LAURENS, SC 29360
Laurens County (864) 833-0055
NICHOLAS KENT PETRUS PA-C
Physician Assistant
22580 HIGHWAY 76 E
LAURENS, SC 29360
Laurens County (864) 939-1070
SELF REGIONAL PHYSICIAN SERVICES
Family Medicine
22580 HIGHWAY 76 E, SUITE 100
LAURENS, SC 29360
Laurens County (864) 833-5986
BRIAN E WEIRICK D.O.
Internal Medicine
22580 HIGHWAY 76 E, SUITE 200
LAURENS, SC 29360
Laurens County (864) 833-0055
LAURA LEE WOLFE
Nurse Practitioner (Family)
22580 HIGHWAY 76 E, SUITE 300
LAURENS, SC 29360
Laurens County (864) 939-1070
SELF MEDICAL GROUP
Family Medicine
22580 HIGHWAY 76 E, SUITE 100
LAURENS, SC 29360
Laurens County (864) 833-5986

Frequently 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.

Does Self Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 42D0950983) is associated with this NPI, valid through September 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Self Medical Group accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, 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.