Individual provider Active NPI

Susan Thrasher Martin, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Anderson, SC
National Provider Identifier
1215991450
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
15577 Issued in SC
Practice address
102 Buford Ave
Suite a
Anderson, SC 29621
Phone
(864) 261-9506
Fax
(864) 226-4201
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 15577 SC Primary

Addresses

Primary practice location

102 Buford Ave
Suite a
Anderson, SC 29621

Mailing address

102 Buford Ave
Suite a
Anderson, SC 29621-3365
Phone (864) 261-9506

Other identifiers 1

IdentifierTypeStateIssuer
155771MedicaidSC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124001447 SC Practitioner - Pathology 7214322700 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ernest C. Martin, M.D., P.a. CurrentSince Dec 18, 2023 Accepting new patients
Upstate Wellness Center LLC CurrentSince Mar 1, 2024 Accepting new patients
Southeastern Clinical Laboratories PA Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

102 Buford Ave
Ste A
Anderson, SC 29621
Phone (864) 224-2325

2076 Woodruff Rd
Greenville, SC 29607
Phone (864) 261-9506

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1215991450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE",
            "address_2": "SUITE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213365",
            "telephone_number": "864-261-9506",
            "fax_number": "864-226-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE",
            "address_2": "SUITE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29621",
            "telephone_number": "864-261-9506",
            "fax_number": "864-226-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SUSAN",
        "middle_name": "THRASHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "15577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155771",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.