Active NPI
Martin D Carmichael, MD
- Family Medicine Physician
- Aynor, SC
National Provider Identifier
1477511053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12073
- Practice address
- 51 Eleventh Avenue
Aynor, SC 29511-3942 - Phone
- (843) 358-3700
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12073 | SC | Primary |
Addresses
Primary practice location
51 Eleventh Avenue
Aynor, SC 29511-3942
Mailing address
300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 234-6827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120737 | Medicaid | SC |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100629000569 | SC | Practitioner - Family Practice | 2264563667 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1477511053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SINGLETON RIDGE RD",
"city": "CONWAY",
"state": "SC",
"postal_code": "295269142",
"telephone_number": "843-234-6827",
"fax_number": "843-234-6990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 ELEVENTH AVENUE",
"city": "AYNOR",
"state": "SC",
"postal_code": "295113942",
"telephone_number": "843-358-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMICHAEL",
"first_name": "MARTIN",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "12073",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120737",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aynor, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.