Active NPI
Julianna Maynor, NURSE PRACTITIONER
- Pediatric Nurse Practitioner
- Mullins, SC
National Provider Identifier
1093049470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 3872
- Practice address
- 2845 E Highway 76
Suite 5
Mullins, SC 29574-6037 - Phone
- (843) 431-2650
- Fax
- (843) 431-2647
- NPI assigned
- Oct 1, 2009
- Last updated
- Jun 1, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 3872 | SC | Primary |
Addresses
Primary practice location
2845 E Highway 76
Suite 5
Mullins, SC 29574-6037
Mailing address
2845 E Highway 76
Suite 5
Mullins, SC 29574-6037
Phone (843) 431-2650
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP0619 | Medicaid | SC | |
| RHC 121 | Medicaid | SC | |
| GP5462 | Other | SC | MEDICAID GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3872 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338508800000",
"number": "1093049470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2845 E HIGHWAY 76",
"address_2": "SUITE 5",
"city": "MULLINS",
"state": "SC",
"postal_code": "295746037",
"telephone_number": "843-431-2650",
"fax_number": "843-431-2647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 E HIGHWAY 76",
"address_2": "SUITE 5",
"city": "MULLINS",
"state": "SC",
"postal_code": "295746037",
"telephone_number": "843-431-2650",
"fax_number": "843-431-2647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNOR",
"first_name": "JULIANNA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2012-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "SC",
"license": "3872",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0619",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RHC 121",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "GP5462",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mullins, SC
- Marion Regional Healthcare System (Advanced Medical Associates)
- Marion SC Emergency Physicians
- Marion School District Seven
- Gangatharan Mathisuthan, M.D
- Maverick Medical Transport LLC (Maverick Medical Transport)
- McLeod Health Cheraw (McLeod Family Medicine-Marion)
- McLeod Physician Associates II (McLeod Family Medicine - Marion County)
- McLeod Physician Associates, Inc (McLeod Family Medicine - Marion County)
- Tammy B McMillan
- McQueen Family Chiropractic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.