Active NPI
Mary Elizabeth Little, MD
- Family Medicine Physician
- Newberry, SC
National Provider Identifier
1205899382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17714
- Practice address
- 2605 Kinard St Ste 200
Newberry, SC 29108-2965 - Phone
- (803) 405-1900
- Fax
- (803) 405-1919
- NPI assigned
- Apr 10, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17714 | SC | Primary |
Addresses
Primary practice location
2605 Kinard St Ste 200
Newberry, SC 29108-2965
Mailing address
79 Gibbes St
Charleston, SC 29401-1806
Phone (843) 937-9412
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17714 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Self Medical Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Greenwood, SC
- NPI 1841047560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559865600000",
"number": "1205899382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 GIBBES ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294011806",
"telephone_number": "843-937-9412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 KINARD ST STE 200",
"city": "NEWBERRY",
"state": "SC",
"postal_code": "291082965",
"telephone_number": "803-405-1900",
"fax_number": "803-405-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LITTLE",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-10",
"last_updated": "2019-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "17714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newberry, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.