FAMILY HEALTHCARE NINETY SIX, A DIVISION OF SELF MEDICAL GROUP
NPI 1609262807
Family Medicine in Ninety Six, SC
About Family Healthcare Ninety Six, A Division Of Self Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY HEALTHCARE NINETY SIX, A DIVISION OF SELF MEDICAL GROUP (NPI 1609262807) is a healthcare organization registered as a family medicine in Ninety Six, South Carolina and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Matthew T Logan, President And Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted 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)
Family Healthcare Ninety Six, A Division Of Self Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
560Medicare enrollment records show 560 clinicians reassign Medicare billing to Family Healthcare Ninety Six, A Division Of Self Medical Group, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 299 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 43
Nearest to this location (20)
See all 560Source: 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 42D0253132
Family Healthcare - Ninety Six · Ninety Six, SCFrequently 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 1609262807. It was assigned to this organization in the NPPES registry on April 14, 2015. The provider is also known as Family Healthcare Ninety Six, A Division Of Self Medical Group.
Where is Self Medical Group located?
Self Medical Group is located at 103 Little Mountain Rd, Ninety Six, SC 29666. The listed phone number is (864) 543-3515.
What is Self Medical Group's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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, 5 practice at this address and 299 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 42D0253132) is associated with this NPI, valid through August 31, 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 from Absolute Total Care, Ambetter of North Carolina and First Choice Next 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.
# Family Healthcare Ninety Six, A Division Of Self Medical Group · NPI 1609262807
Family Medicine organization in Ninety Six, South Carolina. Organization record, active in the CMS NPPES registry since April 14, 2015.
## Identity
- **NPI:** 1609262807 (Entity type: Organization)
- **Enumerated:** April 14, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Self Medical Group
- **Organization subpart:** No
- **Authorized official:** Matthew Logan, PRESIDENT AND CEO
## Practice location
- **Address:** 103 LITTLE MOUNTAIN RD, Ninety Six, SC 29666-9252
- **Phone:** (864) 543-3515
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 560 clinicians in 43 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (95), Nurse Practitioner (87), Emergency Medicine (59); 5 practice at this address and 299 within 10 miles; [full list](https://npiprofile.com/npi/1609262807/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 14, 2021
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1609262807) · Data from the CMS NPPES public registry.