NPIMap

Individual provider Active NPI

Mary Laurel Varghese, NP-C

  • Nurse Practitioner
  • Travelers Rest, SC
National Provider Identifier
1548600547
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20185 Issued in SC
Practice address
6 S Poinsett Hwy
Travelers Rest Internal Medicine
Travelers Rest, SC 29690-1822
Phone
(864) 834-7834
Fax
(864) 834-7477
NPI assigned
Jul 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20185 SC Primary

Addresses

Primary practice location

6 S Poinsett Hwy
Travelers Rest Internal Medicine
Travelers Rest, SC 29690-1822

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 834-7834

Other identifiers 2

IdentifierTypeStateIssuer
003140025AMedicaidGA
NP3996MedicaidSC

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
I20160922001460 SC Practitioner - Nurse Practitioner 0840431433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Physician Services IncGroup PAC ID 6608826821, 106 clinicians

Practice addresses (Care Compare)

1200 Brookfield Blvd
Suite 400B
Greenville, SC 29607-6583
Phone (864) 605-3721

406 N Poinsett Hwy
Travelers Rest, SC 29690-1667
Phone (864) 834-4151

6 S Poinsett Hwy
Travelers Rest, SC 29690-1822
Phone (864) 834-7834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc CurrentSince Aug 1, 2016 Accepting new patients
St Francis Physician Services Inc CurrentSince Aug 1, 2016 Accepting new patients
Uh Internal Medicine Partners Past Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Locations

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

6 S Poinsett Hwy
Travelers Rst, SC 29690
Phone (864) 627-5337

406 N Poinsett Hwy
Travelers Rst, SC 29690
Phone (864) 834-4151

Interoperability endpoints

  • Direct secure messaging: mvarghese1156584@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1548600547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-834-7834",
            "fax_number": "864-834-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 S POINSETT HWY",
            "address_2": "TRAVELERS REST INTERNAL MEDICINE",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901822",
            "telephone_number": "864-834-7834",
            "fax_number": "864-834-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "MARY",
        "middle_name": "LAUREL",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "20185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003140025A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3996",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Travelers Rest, SC

Sources for this page

Verify at the official NPI Registry.