SELF REGIONAL HEALTHCARE
NPI 1619775244
Family Medicine in Ninety Six, SC
About Self Regional Healthcare NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SELF REGIONAL HEALTHCARE (NPI 1619775244), doing business as Family Healthcare Ninety Six, is a healthcare organization registered as a family medicine in Ninety Six, 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
Specialties & Licenses
Other Names 1
Group Practice 1
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.
Clinicians Billing Medicare Through This Organization
231Medicare 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 153 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 26
Nearest to this location (20)
See all 231Source: 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 1619775244. It was assigned to this organization in the NPPES registry on March 7, 2025. The provider is doing business as Family Healthcare Ninety Six.
Where is Self Regional Healthcare located?
Self Regional Healthcare is located at 103 Little Mountain Rd, Ninety Six, SC 29666. The listed phone number is (864) 543-3515.
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, 5 practice at this address and 153 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 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 7, 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.
# Self Regional Healthcare · NPI 1619775244
Family Medicine organization in Ninety Six, South Carolina. Organization record, active in the CMS NPPES registry since March 7, 2025.
## Identity
- **NPI:** 1619775244 (Entity type: Organization)
- **Enumerated:** March 7, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Family Healthcare Ninety Six (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Matthew Logan, PRESIDENT & CEO
## Practice location
- **Address:** 103 LITTLE MOUNTAIN RD, Ninety Six, SC 29666-9252
- **Phone:** (864) 543-3515
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, South Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 231 clinicians in 26 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (76), Nurse Practitioner (65), Obstetrics/Gynecology (19); 5 practice at this address and 153 within 10 miles; [full list](https://npiprofile.com/npi/1619775244/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1619775244) · Data from the CMS NPPES public registry.