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SELF REGIONAL HEALTHCARE
NPI 1225838832
Pediatrics in Greenwood, SC

Active since March 14, 2025CLIA 42D1059808 · Waiver
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: August 09, 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 holds a CLIA Waiver certificate valid through October 5, 2026 and 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
Phone(864) 943-4279
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
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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

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, Molina Healthcare.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 of Waiver 42D1059808

Self Regional Healthcare Pediatric Associates Greenwood · Greenwood, SC
Active · expires 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.

Other Providers at the Same Location NPPES 7

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

MIRANDA FITZGERALD MAGEE APRN
Nurse Practitioner (Family)
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279
DR. LINDA L FUQUA MD
Pediatrics
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279
DR. CECILY S HUGHES MD
Pediatrics
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279
MRS. ELIZABETH HAMMOND C.P.N.P.
Nurse Practitioner (Pediatrics)
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279
JOHN DEVORE COMPTON JR. M.D.
Ophthalmology
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 227-2020
SELF MEDICAL GROUP
Pediatrics
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279
DR. HEATHER S GALLMAN MD
Pediatrics
210 WELLS AVE
GREENWOOD, SC 29646
Greenwood County (864) 943-4279

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.

Does Self Regional Healthcare hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D1059808) is associated with this NPI, valid through October 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Self Regional Healthcare accept?

Health plans from BlueCross BlueShield of South Carolina 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 16 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.