Individual provider Active NPI

Anthony L Mathis, DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Greer, SC
National Provider Identifier
1407825953
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
502 Issued in SC
Practice address
127 Mills Ave
Greer, SC 29651-2514
Phone
(864) 879-4080
Fax
(864) 879-4938
NPI assigned
Mar 16, 2006
Last updated
Nov 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 502 SC Primary

Addresses

Primary practice location

127 Mills Ave
Greer, SC 29651-2514

Mailing address

127 Mills Ave
Greer, SC 29651-2514
Phone (864) 879-4080

Other identifiers 1

IdentifierTypeStateIssuer
GP9948MedicaidSC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329001256 SC Practitioner - Podiatry 1254387582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Podiatry Group PAGroup PAC ID 5698919694, 8 clinicians

Practice addresses (Care Compare)

105 Mimosa Dr
Greer, SC 29650-1737
Phone (864) 399-9070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1057
Removal or shaving of skin growth971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
502SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Podiatry Group, PA Foot & Ankle Surgery CurrentSince Feb 1, 2024 Accepting new patients
Upstate Podiatry Group, PA Foot & Ankle Surgery CurrentSince Feb 1, 2024 Accepting new patients
Greater Greer Pain Relief Center, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

105 Mimosa Dr
Greer, SC 29650
Phone (864) 399-9070

801 SE Main St
Simpsonville, SC 29681
Phone (864) 399-9070

1420 John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 399-9070

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1407825953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MILLS AVE",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296512514",
            "telephone_number": "864-879-4080",
            "fax_number": "864-879-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MILLS AVE",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296512514",
            "telephone_number": "864-879-4080",
            "fax_number": "864-879-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "ANTHONY",
        "middle_name": "L",
        "credential": "DPM LLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9948",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.