PEDIATRIC ASSOCIATES GREENWOOD, A DIVISION OF SELF MEDICAL GROUP
NPI 1720475221
Pediatrics in Greenwood, SC

Active since April 22, 2015
210 WELLS AVE, GREENWOOD, SC 29646(864) 943-4279(864) 223-2642 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 14, 2021, Apr 19, 2021, Apr 13, 2021 (3 updates tracked since 2021).

About Pediatric Associates Greenwood, A Division Of Self Medical Group NPPES

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

PEDIATRIC ASSOCIATES GREENWOOD, A DIVISION OF SELF MEDICAL GROUP (NPI 1720475221) is a healthcare organization registered as a pediatrics in Greenwood, South Carolina and active in the NPI registry since April 2015. The organization lists Matthew T Logan, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1720475221
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSELF MEDICAL GROUP
Location Address210 WELLS AVEGreenwood, SC 29646-3843
Mailing Address210 Wells AveGreenwood, SC 29646-3843 · (864) 943-4279 · Fax (864) 223-2642
Fax(864) 223-2642
Organization SubpartNo
Authorized OfficialMatthew T LoganPresident And Ceo · (864) 725-4253
Enumeration DateApril 22, 2015
Last NPPES UpdateDecember 14, 20213 updates tracked since enumeration
NPPES CertifiedDecember 14, 2021
✔ NPI 1720475221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
210 WELLS AVE, Greenwood, SC 29646

Other Names 1

Other NamePediatric Associates Greenwood, A Division Of Self Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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)

Pediatric Associates Greenwood, A Division Of Self Medical Group 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 Pediatric Associates Greenwood, A Division Of Self Medical Group, which bills Medicare for the services they deliver. Of these, 5 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
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
Family Practice
NPI 1003815358
138 WELLS AVE
Greenwood, SC 29646
(864) 725-4138
✔ PECOS✔ Accepts Medicare0.1 mi
General Surgery
NPI 1639285083
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
Vascular Surgery
NPI 1104131143
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1730728031
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
Gastroenterology
NPI 1811336092
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts Medicare0.1 mi
Nephrology
NPI 1255773784
1123 SPRING ST
Greenwood, SC 29646
(864) 450-9036
✔ PECOS✔ Accepts Medicare0.1 mi
Qualified Audiologist
NPI 1194909333
1015 SPRING ST
Greenwood, SC 29646
(864) 227-0444
0.2 mi
Otolaryngology
NPI 1982788725
1015 SPRING ST
Greenwood, SC 29646
(864) 227-6741
✔ PECOS✔ Accepts Medicare0.2 mi
Internal Medicine
NPI 1194354399
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4111
✔ PECOS✔ Accepts Medicare0.2 mi
Interventional Pain Management
NPI 1780113506
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4095
✔ PECOS✔ Accepts Medicare0.2 mi
Diagnostic Radiology
NPI 1285128892
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4671
✔ PECOS✔ Accepts Medicare0.2 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1053947192
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4111
✔ Accepts Medicare0.2 mi
Psychiatry
NPI 1790125615
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4398
✔ PECOS✔ Accepts Medicare0.2 mi
Anesthesiology
NPI 1639159791
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4111
✔ PECOS✔ Accepts Medicare0.2 mi
Emergency Medicine
NPI 1912000860
1325 SPRING ST
Greenwood, SC 29646
(864) 725-4780
✔ PECOS0.2 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.

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 1720475221. It was assigned to this organization in the NPPES registry on April 22, 2015. The provider is also known as Pediatric Associates Greenwood, A Division Of Self Medical Group.

Where is Self Medical Group located?

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

What is Self Medical Group's specialty?

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

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 302 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Self Medical Group accept?

Health plans from First Choice Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare 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.