Individual provider Active NPI

Marcus Markette Tedder, APRN-BC

  • Gerontology Nurse Practitioner
  • Florence, SC
National Provider Identifier
1407467038
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP000242 Issued in GA
Practice address
1005 E Cheves St Ste 100
Florence, SC 29506-2707
Phone
(843) 777-7900
Fax
(843) 777-7925
NPI assigned
Aug 17, 2020
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP000242 GA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 24230 SC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X GAA-NP000242 GA

Addresses

Primary practice location

1005 E Cheves St Ste 100
Florence, SC 29506-2707

Mailing address

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Other practice location 1

3 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6862
Phone (803) 434-8323

Other practice location 2

109 Doctors Dr
Greenville, SC 29605-5608
Phone (864) 797-7150

Other identifiers 1

IdentifierTypeStateIssuer
NP7151MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201103000503 SC Practitioner - Nurse Practitioner 4183034176 Reassigns benefits to 3 organizations
I20210722004051 GA Practitioner - Nurse Practitioner 4183034176 Reassigns benefits to 3 organizations
I20240515004199 NC Practitioner - Nurse Practitioner 4183034176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-5995

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP000242GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince May 23, 2023 Accepting new patients
Emory Medical Care Foundation Inc Nurse Practitioner Current Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Critical Care Medicine CurrentSince Dec 4, 2021 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2021 Accepting new patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Dec 18, 2023 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jan 15, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince May 23, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 3, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Dec 18, 2023 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Dec 4, 2021 Accepting new patients
Carolinas Physicians Network Inc. Acute Care CurrentSince Jan 3, 2024 Accepting new patients
Emory Medical Care Foundation CurrentSince Jul 1, 2021 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 434-8323

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1005 E Cheves St
Florence, SC 29506
Phone (843) 777-7900

1005 E Cheves St
Ste 100
Florence, SC 29506
Phone (843) 777-7900

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

109 Doctors Dr
Greenville, SC 29605
Phone (864) 797-7035

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: mtedder23411@directmcleodehealth.org
  • Direct secure messaging: mtedder541287@direct.ghs.myhfn.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1407467038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "843-777-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E CHEVES ST STE 100",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062707",
            "telephone_number": "843-777-7900",
            "fax_number": "843-777-7925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Richland Medical Park Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036862",
            "country_code": "US",
            "telephone_number": "803-434-8323",
            "fax_number": "803-434-8326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055608",
            "country_code": "US",
            "telephone_number": "864-797-7150",
            "fax_number": "894-797-7155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDDER",
        "first_name": "MARCUS",
        "middle_name": "MARKETTE",
        "name_prefix": "Mr.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "NP000242",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "24230",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "GAA-NP000242",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7151",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.