Active NPI
Mark E Musselwhite, DO
- Emergency Medicine Physician
- Marietta, OH
National Provider Identifier
1104408566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 91405
- Practice address
- 401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750 - Phone
- (740) 568-5669
- NPI assigned
- Apr 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 91405 | SC | Primary |
Addresses
Primary practice location
401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750
Mailing address
401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750
Phone (740) 568-5669
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240906001247 | SC | Practitioner - Emergency Medicine | 3870033707 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1000
Hospital & facility affiliations
- Anmed Health
- St Francis-Downtown
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Ich ER Services, LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Anmed Health | Emergency Medicine | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000
3970 Grandview Dr
Simpsonville, SC 29680
Phone (864) 255-1000
Interoperability endpoints
- mmusselwhite79281@direct.anmedhealth.net
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Anderson, SC
- NPI 1174002059
Emergency Medicine, SC
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1104408566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 MATTHEW ST",
"address_2": "OUTREACH/FERGUSON BUILDING",
"city": "MARIETTA",
"state": "OH",
"postal_code": "45750",
"telephone_number": "740-568-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 MATTHEW ST",
"address_2": "OUTREACH/FERGUSON BUILDING",
"city": "MARIETTA",
"state": "OH",
"postal_code": "45750",
"telephone_number": "740-568-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSSELWHITE",
"first_name": "MARK",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-26",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "91405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.