NPIMap

Individual provider Active NPI

Mark Landry, MD

  • Otolaryngology Physician
  • Greenville, SC
National Provider Identifier
1215566104
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
95204 Issued in SC
Practice address
200 Patewood Dr Ste B400
Greenville, SC 29615-6306
Phone
(864) 454-4368
Fax
(864) 241-9232
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 95204 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B400
Greenville, SC 29615-6306

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8611

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
I20250807004001 SC Practitioner - Otolaryngology 4587162755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2020
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)

200 Patewood Dr
Suite B400
Greenville, SC 29615-6306
Phone (864) 454-4368

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 8, 2025 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste B400
Greenville, SC 29615
Phone (864) 454-4368

300 E McBee Ave
Ste 300
Greenville, SC 29601

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

105 Carter Park Dr
Ste B
Seneca, SC 29678
Phone (864) 482-3122

Interoperability endpoints

  • Direct secure messaging: mlandry877683@direct.ghs.myhfn.org

Organizations & group practices 2

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 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1215566104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156306",
            "telephone_number": "864-454-4368",
            "fax_number": "864-241-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "95204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.