Mark S Green, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

560 Issued in SC

Practice address

1847 S Lake Dr
Lexington, SC 29073-7759

Phone

(803) 356-8998

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health Urgent Care of South Carolina PCGroup PAC ID 1254703788, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgreen824828@direct.ghs.myhfn.org

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.

• Prisma Health Urgent Care of South Carolina, PC

  • Urgent Care Clinic/Center
  • Greenville, SC
  • NPI 1851000855
  Medicare reassignment Care Compare group
• Novant Health Urgent Cares LLC

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1841026382
  Medicare reassignment
• Sound Physicians Emergency Medicine of South Carolina LLC

  • Emergency Medicine Physician
  • Aiken, SC
  • NPI 1730636168
  Medicare reassignment
• Regional Medical Center of Orangeburg and Calhoun Counties

  • Neurology Physician
  • Orangeburg, SC
  • NPI 1144940347
  NPD
• The Regional Medical Center of Orangeburg and Calhoun Counties

  • Emergency Medicine Physician
  • Orangeburg, SC
  • NPI 1366527566
  NPD
• Liberty Emergency Group LLC

  • Emergency Medicine Physician
  • Hinesville, GA
  • NPI 1073581682

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1396736336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 S LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737759",
            "telephone_number": "803-356-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10040 Two Notch Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292234396",
            "country_code": "US",
            "telephone_number": "803-788-1153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7613 Garners Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292093811",
            "country_code": "US",
            "telephone_number": "839-600-9190",
            "fax_number": "839-600-9195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "560",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetria Graves, OT
• Green Transitions MHT LLC
• Anne Martin Green
• Fertasia Me'Shaun Green, LMSW
• Jasmine Green, M.A. CCC-SLP
• Paula Marie Green
• Erica Greene, RN
• Harley Raye Greene, PHARMD
• Kristen Geneva Greene, PT
• Richard M Greenfield

• Physician Assistant in Lexington, SC
• Providers in Lexington, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.