SELF REGIONAL HEALTHCARE
NPI 1114726460
Family Medicine in Laurens, SC

Active since March 10, 2025
22580 HIGHWAY 76 E, LAURENS, SC 29360(864) 833-5986 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 4, 2026, May 27, 2026, Mar 10, 2025 (3 updates tracked since 2025).

About Self Regional Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SELF REGIONAL HEALTHCARE (NPI 1114726460), doing business as Self Medical Center Laurens, is a healthcare organization registered as a family medicine in Laurens, South Carolina and active in the NPI registry since March 2025. The organization lists Matthew Tolbert Logan, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1114726460
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSELF REGIONAL HEALTHCARE
Location Address22580 HIGHWAY 76 ELaurens, SC 29360-8460
Mailing Address104 Wells AveGreenwood, SC 29646-3837 · (864) 725-4673 · Fax (864) 725-7424
Organization SubpartNo
Authorized OfficialMatthew Tolbert LoganPresident & Ceo · (864) 725-4780
Enumeration DateMarch 10, 2025
Last NPPES UpdateJune 4, 20263 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1114726460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 12

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedSurgeryTaxonomy 208600000X
Also ListedUrologyTaxonomy 208800000X
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
22580 HIGHWAY 76 E, Laurens, SC 29360

Other Names 1

Doing Business AsSelf Medical Center Laurens

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Self Regional Healthcare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateSouth CarolinaEnrollment IDO20051214000767Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

231

Medicare enrollment records show 231 clinicians reassign Medicare billing to Self Regional Healthcare, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 11 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 26

Family Practice76
Nurse Practitioner65
Obstetrics/Gynecology19
Internal Medicine15
Cardiovascular Disease (Cardiology)9
Pediatric Medicine8
Neurology4
Otolaryngology4
18 other specialties31

Nearest to this location (20)

See all 231
Family Practice
NPI 1386963684
22580 HIGHWAY 76 E STE 200
Laurens, SC 29360
(864) 725-1480
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1447997564
22580 HIGHWAY 76 E STE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1285372243
22580 HIGHWAY 76 E STE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1912945841
22580 HIGHWAY 76 E SUITE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1902302516
22580 HIGHWAY 76 E STE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1528001161
22580 HIGHWAY 76 E SUITE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1982647525
22580 HIGHWAY 76 E SUITE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1891738423
22580 HIGHWAY 76 E SUITE 100
Laurens, SC 29360
(864) 833-5986
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1669457966
22580 HIGHWAY 76 E SUITE 200
Laurens, SC 29360
(864) 833-0055
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1093266520
210 S BROAD ST
Clinton, SC 29325
(864) 833-0973
✔ PECOS✔ Accepts Medicare3.6 mi
Nurse Practitioner
NPI 1760710677
210 S BROAD ST
Clinton, SC 29325
(864) 833-0973
✔ PECOS✔ Accepts Medicare3.6 mi
Family Practice
NPI 1992186027
110 HIGHWAY 246 N
Greenwood, SC 29649
(864) 725-1750
✔ PECOS✔ Accepts Medicare17 mi
Nurse Practitioner
NPI 1114635984
167 S GREENWOOD AVE
Ware Shoals, SC 29692
(864) 389-4116
✔ PECOS✔ Accepts Medicare18 mi
Clinical Social Worker
NPI 1164503348
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts Medicare24 mi
Physical Medicine and Rehabilitation
NPI 1972731917
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare24 mi
Neurosurgery
NPI 1457459174
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare24 mi
Clinical Psychologist
NPI 1386808178
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts Medicare24 mi
Pediatric Medicine
NPI 1477873164
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts Medicare24 mi
General Surgery
NPI 1780679241
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare24 mi
Qualified Audiologist
NPI 1902644677
1015 SPRING ST
Greenwood, SC 29646
(864) 227-6741
✔ Accepts Medicare24 mi
See all 231 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Regional Healthcare's NPI number?

The NPI number for Self Regional Healthcare is 1114726460. It was assigned to this organization in the NPPES registry on March 10, 2025. The provider is doing business as Self Medical Center Laurens.

Where is Self Regional Healthcare located?

Self Regional Healthcare is located at 22580 Highway 76 E, Laurens, SC 29360. The listed phone number is (864) 833-5986.

What is Self Regional Healthcare's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Self Regional Healthcare enrolled in Medicare?

Yes. Self Regional Healthcare is registered in the Medicare PECOS enrollment system.

When is Self Regional Healthcare's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (South Carolina, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Self Regional Healthcare?

According to the CMS Revalidation Reassignment List (October 2026 release), 231 clinicians in 26 Medicare specialties reassign their Medicare billing to Self Regional Healthcare. 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 (76), Nurse Practitioner (65) and Obstetrics/Gynecology (19). Of these, 9 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Self Regional Healthcare accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next and 1 other insurer list Self Regional Healthcare 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 Regional Healthcare was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.