Active NPI
Marian Moody
- Registered Nurse
- Manning, SC
National Provider Identifier
1336567239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 956657
- Practice address
- 110 Boyce Street
Dhec Clarendon County Health Dept
Manning, SC 29102 - Phone
- (803) 435-8168
- Fax
- (803) 435-6825
- NPI assigned
- Mar 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 956657 | SC | Primary |
Addresses
Primary practice location
110 Boyce Street
Dhec Clarendon County Health Dept
Manning, SC 29102
Mailing address
110 Boyce Street
Dhec Clarendon County Health Dept
Manning, SC 29102
Phone (803) 435-8168
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 956657 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396051200000",
"number": "1336567239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BOYCE STREET",
"address_2": "DHEC CLARENDON COUNTY HEALTH DEPT",
"city": "MANNING",
"state": "SC",
"postal_code": "29102",
"telephone_number": "803-435-8168",
"fax_number": "803-435-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BOYCE STREET",
"address_2": "DHEC CLARENDON COUNTY HEALTH DEPT",
"city": "MANNING",
"state": "SC",
"postal_code": "29102",
"telephone_number": "803-435-8168",
"fax_number": "803-435-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "MARIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-29",
"last_updated": "2014-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "956657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manning, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.