NPIMap

Individual provider Active NPI

Christian Carl Mabry

  • Anesthesiology Physician
  • Greenville, SC
National Provider Identifier
1063736098
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
84795 Issued in SC
Practice address
67 Creekside Park CT
Greenville, SC 29615-4810
Phone
(864) 522-3700
NPI assigned
Mar 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 282706-1 NY
Anesthesiology Physician 207L00000X 25MA09290100 NJ
Anesthesiology Physician 207L00000X 84795 SC Primary

Addresses

Primary practice location

67 Creekside Park CT
Greenville, SC 29615-4810

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other names 1

  • Carl Christian Mabry Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmabry373240@direct.ghs.myhfn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201209001784 SC Practitioner - AnesthesiologyPractitioner - Internal Medicine 0547415515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 296-5137

175 Patewood Dr
Greenville, SC 29615-3570
Phone (864) 797-1403

5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-6151

67 Creekside Park CT
Greenville, SC 29615-4810
Phone (864) 522-3700

701 Grove Rd
Greenville, SC 29605-4210

830 S Buncombe Rd
Greer, SC 29650-2400
Phone (864) 455-2455

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09290100NJMDAnesthesiology Physician
282706-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Nov 2, 2020 Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Nov 2, 2020 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Parish Hospital Service District for the Parish of Orleans Dist a Past Accepting new patients

Locations

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

Interoperability endpoints

  • Direct secure messaging: cmabry373240@direct.ghs.myhfn.org

Organizations & group practices 4

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.

Hospital & facility affiliations 52

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1063736098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CREEKSIDE PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154810",
            "telephone_number": "864-522-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "CHRISTIAN",
        "middle_name": "CARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "282706-1",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09290100",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "84795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmabry373240@direct.ghs.myhfn.org",
            "affiliation": "N",
            "address_1": "67 Creekside Park Ct",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296154810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARL",
            "last_name": "MABRY",
            "middle_name": "CHRISTIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.