NPIMap

Organization Active NPI

Mark D. Naquin MD PA

  • Anesthesiology Physician
  • Aiken, SC
National Provider Identifier
1043564602
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MARK D. NAQUIN MD PA
Practice address
4211 Trolley Line Rd
Aiken, SC 29801-2749
Phone
(803) 648-2840
Fax
(803) 648-8117
NPI assigned
Nov 5, 2012
Last updated
Nov 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Mark D Naquin, MD
Title
President
Phone
(864) 351-9516

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiologist Assistant 367H00000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

4211 Trolley Line Rd
Aiken, SC 29801-2749

Mailing address

PO Box 1078
Cowpens, SC 29330-1078

National Provider Directory

National Provider Directory

Locations

4211 Trolley Line Rd
Aiken, SC 29801
Phone (803) 306-7733

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1043564602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "COWPENS",
            "state": "SC",
            "postal_code": "293301078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 TROLLEY LINE RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298012749",
            "telephone_number": "803-648-2840",
            "fax_number": "803-648-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D. NAQUIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "NAQUIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-351-9516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.