Mary Lyn Barnette

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4264 Issued in SC

Practice address

207 Three Bridges Rd
Greenville, SC 29611-7549

Phone

(864) 220-1110

Fax

(864) 220-1104

NPI assigned

May 25, 2021

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmitchell568560@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD (past)
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  • Nurse Practitioner
  • Greenville, SC
  • NPI 1053786483
  NPD

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1104491703",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 THREE BRIDGES RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296117549",
            "telephone_number": "864-220-1110",
            "fax_number": "864-220-1104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Harper Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297458301",
            "country_code": "US",
            "telephone_number": "803-627-6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNETTE",
        "first_name": "MARY",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4264",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Barnett
• Ryan Benjamin Barnett, PHARMD
• Valinda Theresa Barnett
• Betsy E Barnette, M ED
• Brooke Elizabeth Barnette
• Renee Barnette
• Callie Cook Barnwell, M.D.
• Eve Margaret Baron, PT, DPT, PRPC
• Azadeh Barr, LPC
• Bonnie Lisa Barr, M.D.

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.