Mary Kaye Favaro, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6170 Issued in SC

Practice address

1407 Southwood Dr
Surfside Beach, SC 29575-5365

Phone

(843) 215-6992

Fax

(843) 215-9409

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Little River Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Little River, SC
  • NPI 1629021076

  Family Medicine, SC

  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1144472119

  Family Medicine

  NPD
• Aiken Integrated Medical, PC

  • Neurology Chiropractor
  • Aiken, SC
  • NPI 1184710287

  Family Medicine

  NPD (past)
• Strong Health Chiropractic LLC

  • Neurology Chiropractor
  • Aiken, SC
  • NPI 1184818593
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043326036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 SOUTHWOOD DR",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755365",
            "telephone_number": "843-215-6992",
            "fax_number": "843-215-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SOUTHWOOD DR",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755365",
            "telephone_number": "843-215-6992",
            "fax_number": "843-215-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVARO",
        "first_name": "MARY",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "6170",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "17183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DRS Cloninger and Reimels LLC
• Dunes Dental Services Inc
• Jeff L. Eggart, M.D.
• Beth E. Ehlen, LISW-CP
• Executive Court Medical Specialist P.C.
• Shelley Fegett
• Firefly Chiropractic LLC
• Michelle Fleischmann, CCC-SLP
• Linda Fonvielle
• Jeanne L. Fourrier, D.D.S.

• All providers in Surfside Beach, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.