Active NPI
Mariah Jordan Svantesson, PA
- Physician Assistant
- Mount Pleasant, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0006527
- Practice address
- 851 Leonard Fulghum Dr Ste 101
Mount Pleasant, SC 29464-3793 - Phone
- (843) 971-9350
- Fax
- (843) 971-9351
- NPI assigned
- Oct 30, 2018
- Last updated
- Feb 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0006527 | CO | Primary |
| Surgical Physician Assistant | 363AS0400X | 3098 | SC | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 3098 | SC |
Addresses
Primary practice location
851 Leonard Fulghum Dr Ste 101
Mount Pleasant, SC 29464-3793
Mailing address
851 Leonard Fulghum Dr Ste 101
Mount Pleasant, SC 29464-3793
Phone (843) 971-9350
Other practice location 1
1601 E 19th Ave Ste 6100
Denver, CO 80218-1255
Phone (303) 322-2206
Other names 1
- Mariah Jordan McCallum
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MARIAH.MCCALLUM@hca3.eclinicaldirectplus.com |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 881-0100
851 Leonard Fulghum Dr
Mt Pleasant, SC 29464-3793
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.63 of 100
- Quality
- 80.11
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 68.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3098 | SC | MD | Sports Medicine (Orthopaedic Surgery) Physician |
| PA.0006527 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Cooper Physician Group LLC | Current | Accepting new patients | |
| East Cooper Physician Group LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
7 S Alliance Dr
Ste 111B
Goose Creek, SC 29445
Phone (843) 352-4154
3400 Salterbeck St
Ste 100B
Mt Pleasant, SC 29466
Phone (843) 856-3262
851 Leonard Fulghum Dr
Ste 101
Mt Pleasant, SC 29464
Phone (843) 884-2133
Interoperability endpoints
- mariah.mccallum@hca3.eclinicaldirectplus.com
- mariah.svantesson.1@30548.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Daniel Island, SC
- NPI 1861253981
-
dba Novant Health Diagnostic Imaging at East Cooper
- Body Imaging Physician
- Mount Pleasant, SC
- NPI 1699641571
-
dba East Cooper Center for Pelvic Medicine
- Obstetrics & Gynecology Physician
- Mount Pleasant, SC
- NPI 1922879469
-
dba Novant Health Orthopedics & Sports Medicine
- Orthopaedic Surgery Physician
- Charlotte, NC
- NPI 1043375033
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Novant Health East Cooper Medical Center
- General Acute Care Hospital
- Mount Pleasant, SC
- NPI 1841069044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1538636345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "851 LEONARD FULGHUM DR STE 101",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643793",
"telephone_number": "843-971-9350",
"fax_number": "843-971-9351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 LEONARD FULGHUM DR STE 101",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643793",
"telephone_number": "843-971-9350",
"fax_number": "843-971-9351"
}
],
"practiceLocations": [
{
"address_1": "1601 E 19th Ave Ste 6100",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802181255",
"country_code": "US",
"telephone_number": "303-322-2206",
"fax_number": "303-861-0191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SVANTESSON",
"first_name": "MARIAH",
"middle_name": "JORDAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-30",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0006527",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "SC",
"license": "3098",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "SC",
"license": "3098",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MARIAH.MCCALLUM@hca3.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "1601 E 19th Ave Ste 6100",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802181255",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARIAH",
"last_name": "MCCALLUM",
"middle_name": "JORDAN",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.