Active NPI
Susan Thrasher Martin, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Anderson, SC
National Provider Identifier
1215991450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 15577
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155771 | Medicaid | SC |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ernest C. Martin, M.D., P.a. | Current | Accepting new patients | |
| Upstate Wellness Center LLC | Current | 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.
-
- Psychiatry Physician
- Anderson, SC
- NPI 1871555896
-
- Psychiatry Physician
- Anderson, SC
- NPI 1871362459
-
- Anatomic Pathology & Clinical Pathology Physician
- Toccoa, GA
- NPI 1548224256
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.