NPIMap

Individual provider Active NPI

Stefanie J Martinez, NP

  • Nurse Practitioner
  • Easley, SC
National Provider Identifier
1427001106
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2659 Issued in SC
Practice address
109 Fleetwood Dr Ste a
Easley, SC 29640-2019
Phone
(864) 442-7618
Fax
(864) 442-7155
NPI assigned
May 17, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2659 SC Primary

Addresses

Primary practice location

109 Fleetwood Dr Ste a
Easley, SC 29640-2019

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

200 Fleetwood Dr Ste 100
Easley, SC 29640-2022
Phone (864) 442-7618

Other identifiers 3

IdentifierTypeStateIssuer
NP1139MedicaidSC
1528299732OtherSCNPI FOR FLEETWOOD CONVENIENT CARE/MEDICAL CENTER EASLEY
AA1139 6952MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060912000381 SC Practitioner - Nurse Practitioner 1254335961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

109 Fleetwood Dr
Easley, SC 29640-2019

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 1, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 1, 2018 Accepting new patients
United Emergency Services, Inc. Nurse Practitioner Past Accepting new patients
Sheridan Emergency Physician Services of South Carolina, PA Nurse Practitioner Past Accepting new patients

Locations

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

200 Fleetwood Dr
#4
Easley, SC 29640

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

109 Fleetwood Dr
#A
Easley, SC 29640
Phone (864) 442-7618

200 Fleetwood Dr
Ste 100
Easley, SC 29640
Phone (864) 442-7618

109 Fleetwood Dr
Easley, SC 29640
Phone (864) 644-8303

106 John St
Easley, SC 29640
Phone (864) 859-2220

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

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

15 Roe Rd
Greenville, SC 29611
Phone (864) 295-2308

300 W Front St
Liberty, SC 29657
Phone (864) 843-5605

Interoperability endpoints

  • Direct secure messaging: smartinez172994@direct.ghs.myhfn.org

Organizations & group practices 5

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.

Hospital & facility affiliations 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1427001106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FLEETWOOD DR STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402019",
            "telephone_number": "864-442-7618",
            "fax_number": "864-442-7155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Fleetwood Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296402022",
            "country_code": "US",
            "telephone_number": "864-442-7618",
            "fax_number": "864-442-7155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "STEFANIE",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1139",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR FLEETWOOD CONVENIENT CARE/MEDICAL CENTER EASLEY",
            "identifier": "1528299732",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AA1139 6952",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.