Individual provider Active NPI

Mark H Princell, MD

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1427005693
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12832 Issued in SC
Practice address
701 Congaree Rd
Greenville, SC 29607-3519
Phone
(864) 458-7289
Fax
(864) 458-9462
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12832 SC Primary
Emergency Medicine Physician 207P00000X 012832 SC

Addresses

Primary practice location

701 Congaree Rd
Greenville, SC 29607-3519

Mailing address

PO Box 2168
Spartanburg, SC 29304-2168
Phone (864) 560-4304

Other practice location 1

2755 South Highway 14
Greer, SC 29650-4902
Phone (864) 879-1948

Other identifiers 3

IdentifierTypeStateIssuer
215514OtherSCMEDCOST
128329MedicaidSC
7004322OtherSCAETNA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000570 SC Practitioner - Emergency Medicine 3375595093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wright State University Boonshoft School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

701 Congaree Rd
Greenville, SC 29607-3519
Phone (864) 458-7289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12832SCMDRegistered Nurse
012832SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

701 Congaree Rd
Greenville, SC 29607
Phone (864) 248-4100

230 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 591-2261

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1427005693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293042168",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 CONGAREE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073519",
            "telephone_number": "864-458-7289",
            "fax_number": "864-458-9462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2755 South Highway 14",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296504902",
            "country_code": "US",
            "telephone_number": "864-879-1948",
            "fax_number": "864-560-4413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCELL",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "12832",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "012832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "215514",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128329",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7004322",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.