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WESTERN CAROLINA PSYCHIATRIC ASSOCIATES A DIVISION OF SELF MEDICAL GRO
NPI 1205141371
Psychiatry & Neurology - Psychiatry in Greenwood, SC

Active since August 13, 2010CLIA 42D2099914 · Waiver
1033 EDGEFIELD ST, GREENWOOD, SC 29646(864) 227-3908(864) 227-2668 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Western Carolina Psychiatric Associates A Division Of Self Medical Gro NPPES

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

WESTERN CAROLINA PSYCHIATRIC ASSOCIATES A DIVISION OF SELF MEDICAL GRO (NPI 1205141371) is a healthcare organization registered as a psychiatry in Greenwood, South Carolina and active in the NPI registry since August 2010. The organization holds a CLIA Waiver certificate valid through August 3, 2027 and lists Matthew T Logan, President And Chief Executive Offic, as its authorized official.

NPPES Registry Identity

NPI1205141371
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameSELF MEDICAL GROUP
Location Address1033 EDGEFIELD STGreenwood, SC 29646-3205
Mailing Address1033 Edgefield StGreenwood, SC 29646-3205 · (864) 227-3908 · Fax (864) 227-2668
Phone(864) 227-3908
Fax(864) 227-2668
Organization SubpartNo
Authorized OfficialMatthew T LoganPresident And Chief Executive Offic · (864) 725-4253
Enumeration DateAugust 13, 2010
Last NPPES UpdateDecember 14, 2021
NPPES CertifiedDecember 14, 2021
✔ NPI 1205141371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1033 EDGEFIELD ST, Greenwood, SC 29646
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Other Names 1

Other NameWestern Carolina Psychiatric Associates A Division Of Self Medical Gro

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

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

Western Carolina Psychiatric Associates A Division Of Self Medical Gro is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

560

Medicare enrollment records show 560 clinicians reassign Medicare billing to Western Carolina Psychiatric Associates A Division Of Self Medical Gro, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 302 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 43

Family Practice95
Nurse Practitioner87
Emergency Medicine59
Certified Registered Nurse Anesthetist (CRNA)36
Internal Medicine34
Anesthesiology24
Diagnostic Radiology22
Gastroenterology17
35 other specialties186

Nearest to this location (20)

See all 560
Emile Barrouk, MD
Psychiatry
NPI 1346479847
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Machelle Bolden
Mental Health Counselor
NPI 1043995236
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Jennifer Duffie, LISW-CP
Clinical Social Worker
NPI 1154316404
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Kelly Gallagher-Kiley, LCSW
Clinical Social Worker
NPI 1164503348
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Ashtyn Kinney, LPC
Mental Health Counselor
NPI 1396432423
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Peggy Manalich, MSW
Clinical Social Worker
NPI 1225064462
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Drenda Sheek, LPC
Mental Health Counselor
NPI 1427513696
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Christie Trick, LCSW-CP
Clinical Social Worker
NPI 1851586796
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts MedicareSame address
Michael White, MD
Family Practice
NPI 1003815358
138 WELLS AVE
Greenwood, SC 29646
(864) 725-4138
✔ PECOS✔ Accepts Medicare0.2 mi
Linda Fuqua, MD
Pediatric Medicine
NPI 1336107879
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOS0.2 mi
Elizabeth Hammond, C.P.N.P.
Nurse Practitioner
NPI 1508870635
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOS0.2 mi
Heather Armstrong, AU.D.
Qualified Audiologist
NPI 1194909333
1015 SPRING ST
Greenwood, SC 29646
(864) 227-0444
0.3 mi
William Isenhower, MD
Otolaryngology
NPI 1982788725
1015 SPRING ST
Greenwood, SC 29646
(864) 227-6741
✔ PECOS✔ Accepts Medicare0.3 mi
John Konsek, MD
General Surgery
NPI 1639285083
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.3 mi
Anas Abdel Azim, M.D., M.SC
Vascular Surgery
NPI 1104131143
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.3 mi
Guy Dooley, D.O.
Gastroenterology
NPI 1811336092
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.3 mi
Dipesh Maan, M.D.
Nephrology
NPI 1255773784
1123 SPRING ST
Greenwood, SC 29646
(864) 450-9036
✔ PECOS✔ Accepts Medicare0.3 mi
Karl Boellert, M.D., M.P.H.
Physical Medicine and Rehabilitation
NPI 1972731917
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare0.3 mi
John Cole, M.D.
Neurosurgery
NPI 1457459174
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare0.3 mi
Tinu Abraham, MD
Internal Medicine
NPI 1194354399
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4111
✔ PECOS✔ Accepts Medicare0.4 mi
See all 560 clinicians

Source: 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 of Waiver 42D2099914

Western Carolina Psychiatric Associates · Greenwood, SC
Active · expires Aug 3, 2027
CLIA Number42D2099914
Laboratory TypePhysician Office
Certificate Effective DateAugust 4, 2025
Certificate Expiration DateAugust 3, 2027
Laboratory DirectorVioleta Nistor
Laboratory Phone(864) 227-3908
Laboratory LocationWestern Carolina Psychiatric Associates1033 Edgefield Street, Greenwood, SC 29646
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1205141371. It was assigned to this organization in the NPPES registry on August 13, 2010. The provider is also known as Western Carolina Psychiatric Associates A Division Of Self Medical Gro.

Where is Self Medical Group located?

Self Medical Group is located at 1033 Edgefield St, Greenwood, SC 29646. The listed phone number is (864) 227-3908.

What is Self Medical Group's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

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, 8 practice at this address and 302 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Self Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2099914) is associated with this NPI, valid through August 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Self Medical Group 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 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.