SELF REGIONAL HEALTHCARE
NPI 1225838832
Pediatrics in Greenwood, SC

Active since March 14, 2025
210 WELLS AVE, GREENWOOD, SC 29646(864) 943-4279(864) 223-2642 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Self Regional Healthcare NPPES

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

SELF REGIONAL HEALTHCARE (NPI 1225838832), doing business as Pediatric Associates Greenwood, is a healthcare organization registered as a pediatrics in Greenwood, 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

NPI1225838832
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSELF REGIONAL HEALTHCARE
Location Address210 WELLS AVEGreenwood, SC 29646-3843
Mailing Address104 Wells AveGreenwood, SC 29646-3837 · (864) 725-4673 · Fax (864) 725-7424
Fax(864) 223-2642
Organization SubpartNo
Authorized OfficialMatthew Tolbert LoganPresident & Ceo · (864) 725-4780
Enumeration DateMarch 14, 2025
NPPES CertifiedMarch 14, 2025
✔ NPI 1225838832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
210 WELLS AVE, Greenwood, SC 29646

Other Names 1

Doing Business AsPediatric Associates Greenwood

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

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, 5 practice at this address and 156 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
Pediatric Medicine
NPI 1336107879
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOSSame address
Pediatric Medicine
NPI 1760431886
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOSSame address
Nurse Practitioner
NPI 1508870635
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOSSame address
Pediatric Medicine
NPI 1508818360
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOSSame address
Nurse Practitioner
NPI 1235885146
210 WELLS AVE
Greenwood, SC 29646
(864) 943-4279
✔ PECOSSame address
Nurse Practitioner
NPI 1730728031
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
General Surgery
NPI 1780679241
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1710959424
SELF MEDICAL GROUP - FAMILY HEALTHCARE OF GREENWOOD 116 VENTURE COURT
Greenwood, SC 29649
(864) 725-5594
✔ PECOS✔ Accepts Medicare0.1 mi
Nephrology
NPI 1255773784
1123 SPRING ST
Greenwood, SC 29646
(864) 450-9036
✔ PECOS✔ Accepts Medicare0.1 mi
Clinical Psychologist
NPI 1386808178
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts Medicare0.2 mi
Pediatric Medicine
NPI 1477873164
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts Medicare0.2 mi
Qualified Audiologist
NPI 1902644677
1015 SPRING ST
Greenwood, SC 29646
(864) 227-6741
✔ Accepts Medicare0.2 mi
Otolaryngology
NPI 1982788725
1015 SPRING ST
Greenwood, SC 29646
(864) 227-6741
✔ PECOS✔ Accepts Medicare0.2 mi
Interventional Pain Management
NPI 1780113506
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4095
✔ PECOS✔ Accepts Medicare0.2 mi
Anesthesiology
NPI 1578596995
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4095
✔ PECOS✔ Accepts Medicare0.2 mi
Pain Management
NPI 1154909612
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4095
✔ PECOS0.2 mi
Physical Medicine and Rehabilitation
NPI 1972731917
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare0.2 mi
Neurosurgery
NPI 1457459174
115 ACADEMY AVE
Greenwood, SC 29646
(864) 725-7272
✔ PECOS✔ Accepts Medicare0.2 mi
Clinical Social Worker
NPI 1164503348
1033 EDGEFIELD ST
Greenwood, SC 29646
(864) 227-3908
✔ PECOS✔ Accepts Medicare0.2 mi
Geriatric Medicine
NPI 1801048202
102 KATIE CT
Greenwood, SC 29646
(864) 725-7799
✔ PECOS0.4 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.

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 42D1059808

Self Regional Healthcare Pediatric Associates Greenwood · Greenwood, SC
Expired · Oct 5, 2026
CLIA Number42D1059808
Laboratory TypePhysician Office
Certificate Effective DateOctober 6, 2024
Certificate Expiration DateOctober 5, 2026
Laboratory DirectorHeather S. Gallman
Laboratory Phone(864) 943-4279
Laboratory LocationSelf Regional Healthcare Pediatric Associates Greenwood210 Wells Ave, 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 Regional Healthcare's NPI number?

The NPI number for Self Regional Healthcare is 1225838832. It was assigned to this organization in the NPPES registry on March 14, 2025. The provider is doing business as Pediatric Associates Greenwood.

Where is Self Regional Healthcare located?

Self Regional Healthcare is located at 210 Wells Ave, Greenwood, SC 29646. The listed phone number is (864) 943-4279.

What is Self Regional Healthcare's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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, 5 practice at this address and 156 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 BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare 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 March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.