Active NPI
Mark A Demoss, MD
- Pediatrics Physician
- Greer, SC
National Provider Identifier
1538172960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20597
- Practice address
- 501C Memorial Dr Ext
Greer, SC 29651 - Phone
- (864) 877-1220
- Fax
- (864) 877-7731
- NPI assigned
- Aug 15, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20597 | SC | Primary |
Addresses
Primary practice location
501C Memorial Dr Ext
Greer, SC 29651
Mailing address
501C Memorial Dr Ext
Greer, SC 29651
Phone (864) 877-1220
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562212236 | Other | CHAMPUS | |
| GP2981 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20597 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Medical Center | Past | Accepting new patients |
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.
-
- Specialist
- Greenville, SC
- NPI 1881763068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1538172960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501C MEMORIAL DR EXT",
"city": "GREER",
"state": "SC",
"postal_code": "29651",
"telephone_number": "864-877-1220",
"fax_number": "864-877-7731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501C MEMORIAL DR EXT",
"city": "GREER",
"state": "SC",
"postal_code": "29651",
"telephone_number": "864-877-1220",
"fax_number": "864-877-7731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOSS",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "20597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "562212236",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP2981",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greer, SC
- Joshua Deese, PT, DPT
- Ronald G Degarmo, DO
- Nigel Patrick Delahunty, MD
- Leslie Carol Demars, M.A.CCC-SLP
- Geetika Dembla, M.D.
- Celia Seigler Deneen, M.ED.
- Kristin Marie Dennis, DPT
- Ashlee N. Denooy, L.P.T.
- Dental Professional of South Carolina, P.C. (Family Dentistry at Riverside Crossing)
- Dental Professionals of SC, PC (Greer Family Dental Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.