| Montgomery Center For Family Medicine Of Srh | |
|
155 Academy Ave Greenwood SC 29646-3869 | |
| (864) 725-4865 | |
| (864) 725-4883 |
| Full Name | Montgomery Center For Family Medicine Of Srh |
|---|---|
| Speciality | Family Medicine |
| Location | 155 Academy Ave, Greenwood, South Carolina |
| Authorized Official Name and Position | Matthew T Logan (PRESIDENT & CEO) |
| Authorized Official Contact | 8647254253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Center For Family Medicine Of Srh 155 Academy Ave Greenwood SC 29646-3808 Ph: (864) 725-4865 | Montgomery Center For Family Medicine Of Srh 155 Academy Ave Greenwood SC 29646-3869 Ph: (864) 725-4865 |
| NPI Number | 1326067703 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 12/14/2021 |
| Medicare PECOS PAC ID | 4082527742 |
|---|---|
| Medicare Enrollment ID | O20051214000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326067703 | NPI | - | NPPES |
| CE6182 | Other | MEDICARE RR GROUP NUMBER | |
| PC3251 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 038 (South Carolina) | Primary |
| Provider Name | Michael B Gentry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730182064 PECOS PAC ID: 6103879010 Enrollment ID: I20050302000778 |
| Provider Name | Daphne J Karel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336166339 PECOS PAC ID: 3971501909 Enrollment ID: I20061129000207 |
| Provider Name | Harvey F Hatcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053338061 PECOS PAC ID: 0840290375 Enrollment ID: I20070108000347 |
| Provider Name | Samuel L Clarke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275566119 PECOS PAC ID: 1456353259 Enrollment ID: I20070207000539 |
| Provider Name | Mark Vanswol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114956950 PECOS PAC ID: 4284730995 Enrollment ID: I20070426000001 |
| Provider Name | Robert Tiller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235156233 PECOS PAC ID: 8426155961 Enrollment ID: I20070517000743 |
| Provider Name | Jonathan H Hegler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952382277 PECOS PAC ID: 4587764295 Enrollment ID: I20070711000032 |
| Provider Name | Phillip C Greig |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851491633 PECOS PAC ID: 4688650690 Enrollment ID: I20071003000247 |
| Provider Name | John H Cathcart |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1649375684 PECOS PAC ID: 0143204230 Enrollment ID: I20080507000462 |
| Provider Name | Daniel D Divilbiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316979982 PECOS PAC ID: 9436228251 Enrollment ID: I20080520000651 |
| Provider Name | Gray M Buchanan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386808178 PECOS PAC ID: 6507921343 Enrollment ID: I20090211000567 |
| Provider Name | David P Sealy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861419863 PECOS PAC ID: 8628000429 Enrollment ID: I20090407000435 |
| Provider Name | Lyle Lesesne Pritchard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518986223 PECOS PAC ID: 8426180829 Enrollment ID: I20100721000296 |
| Provider Name | Anthony R Timms |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083719009 PECOS PAC ID: 7214911312 Enrollment ID: I20100819000093 |
| Provider Name | Hugh Coleman Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700819646 PECOS PAC ID: 3577759463 Enrollment ID: I20101117001363 |
| Provider Name | Sharai Correll Amaya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437279254 PECOS PAC ID: 7315071206 Enrollment ID: I20110401000362 |
| Provider Name | Jay Randall Erickson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558363077 PECOS PAC ID: 5092972703 Enrollment ID: I20120208000710 |
| Provider Name | John G Eichelberger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154386019 PECOS PAC ID: 8527220979 Enrollment ID: I20120501000012 |
| Provider Name | Steven P Carter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770549248 PECOS PAC ID: 0143482679 Enrollment ID: I20120501000041 |
| Provider Name | Amy Y Forrest |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477501013 PECOS PAC ID: 3870755309 Enrollment ID: I20120501000057 |
| Provider Name | John A Russell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619925294 PECOS PAC ID: 8224290754 Enrollment ID: I20120501000089 |
| Provider Name | Jacob M Ringenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336433010 PECOS PAC ID: 1254588791 Enrollment ID: I20120905000800 |
| Provider Name | Katherine Gw Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851739676 PECOS PAC ID: 2961628318 Enrollment ID: I20140722000206 |
| Provider Name | Andrea R Gregory |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477873164 PECOS PAC ID: 0042430712 Enrollment ID: I20140930002583 |
| Provider Name | Austin N Rampey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942613377 PECOS PAC ID: 9537471511 Enrollment ID: I20150706000184 |
| Provider Name | Lauren Hearn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043698079 PECOS PAC ID: 4284926148 Enrollment ID: I20160713001399 |
| Provider Name | Michael Josiah Maughon |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1629003751 PECOS PAC ID: 0446428742 Enrollment ID: I20160906002060 |
| Provider Name | Benjamin J Velky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083063507 PECOS PAC ID: 1254609613 Enrollment ID: I20170608000994 |
| Provider Name | Joy Caroline Draper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083753768 PECOS PAC ID: 8921029133 Enrollment ID: I20180502002699 |
| Provider Name | Megan Renee Wright Nguyen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124467667 PECOS PAC ID: 9537393202 Enrollment ID: I20190124002523 |
| Provider Name | Alexandra Ann Shurling |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013399914 PECOS PAC ID: 3375870454 Enrollment ID: I20190813000107 |
| Provider Name | Casey Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770019507 PECOS PAC ID: 7315378379 Enrollment ID: I20200507002877 |
| Provider Name | Helen L Grey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407470198 PECOS PAC ID: 7810397734 Enrollment ID: I20210615002037 |
| Provider Name | Shelby Danielle Crawford |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811457195 PECOS PAC ID: 3274954607 Enrollment ID: I20230629002806 |
| Provider Name | Karla P Madrid Rivas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447601257 PECOS PAC ID: 4981030327 Enrollment ID: I20240401000586 |
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