Organization Active NPI

Geode Health of South Carolina, LLC

  • Psychiatry Physician
  • Fort Mill, SC
National Provider Identifier
1295655587
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GEODE HEALTH OF SOUTH CAROLINA, LLC
Practice address
111 Clebourne St Ste 310
Fort Mill, SC 29715-1758
Phone
(888) 902-1704
NPI assigned
Jul 17, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Brandy Marriner
Title
Credentialing Manager
Phone
(630) 912-4241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

111 Clebourne St Ste 310
Fort Mill, SC 29715-1758

Mailing address

1211 W 22ND St Ste 406
Oak Brook, IL 60523-2169
Phone (888) 902-1704

National Provider Directory

National Provider Directory

Locations

111 Clebourne St
Ste 310
Fort Mill, SC 29715

NPI Registry JSON

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

{
    "created_epoch": "1784246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1295655587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W 22ND ST STE 406",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232169",
            "telephone_number": "888-902-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CLEBOURNE ST STE 310",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297151758",
            "telephone_number": "888-902-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEODE HEALTH OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-17",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "MARRINER",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-912-4241"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.