NPIMap

Individual provider Active NPI

Mary Camille Hiott Nutter, MD

  • Family Medicine Physician
  • Manning, SC
National Provider Identifier
1528265998
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30103 Issued in SC
Practice address
12 W South St
Manning, SC 29102-2925
Phone
(803) 433-4124
NPI assigned
Jun 29, 2007
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 LL30103 SC
Family Medicine Physician 207Q00000X 30103 SC Primary

Addresses

Primary practice location

12 W South St
Manning, SC 29102-2925

Mailing address

360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414

Other identifiers 1

IdentifierTypeStateIssuer
301033MedicaidSC

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
I20150729007960 SC Practitioner - Family Practice 2365756749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hopehealth, Inc.Group PAC ID 4082510623, 77 clinicians

Practice addresses (Care Compare)

12 W S St
Manning, SC 29102-2925
Phone (803) 433-4321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL30103SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hopehealth, Inc CurrentSince Jul 10, 2023 Accepting new patients
Hopehealth Inc CurrentSince Jul 10, 2023 Accepting new patients
Hopehealth Inc Current Accepting new patients

Locations

360 N Irby St
Florence, SC 29501
Phone (843) 656-0353

600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390

12 W South St
Manning, SC 29102
Phone (803) 433-4124

12 W South St
#B
Manning, SC 29102

Organizations & group practices 3

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 5

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1528265998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W SOUTH ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022925",
            "telephone_number": "803-433-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "MARY",
        "middle_name": "CAMILLE HIOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL30103",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "30103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301033",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.