NPIMap

Individual provider Active NPI

Marilyn Anjum

  • Family Nurse Practitioner
  • Conway, SC
National Provider Identifier
1578359014
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30109 Issued in SC
Practice address
2701 Church St Ste a
Conway, SC 29526-4422
Phone
(843) 365-0295
Fax
(843) 365-0354
NPI assigned
Apr 18, 2025
Last updated
Jan 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30109 SC Primary

Addresses

Primary practice location

2701 Church St Ste a
Conway, SC 29526-4422

Mailing address

300 Singleton Ridge Rd
Attn Credentialing
Conway, SC 29526-9142

Other practice location 1

2367B Cypress Cir
Conway, SC 29526-8921
Phone (843) 349-1001

Other identifiers 1

IdentifierTypeStateIssuer
NN1397MedicaidSC

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
I20250804003176 SC Practitioner - Nurse Practitioner 6507374204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

2701 Church St
Suite a
Conway, SC 29526-4422
Phone (843) 365-0295

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30109SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince Jun 15, 2025 Accepting new patients
Conway Hospital, Inc. CurrentSince Jun 15, 2025 Accepting new patients
Conway Hospital, Inc. Internal Medicine Past Accepting new patients

Locations

2367B Cypress Cir
Conway, SC 29526
Phone (843) 349-1001

2701 Church St
Ste A
Conway, SC 29526
Phone (843) 347-8041

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1578359014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHURCH ST STE A",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264422",
            "telephone_number": "843-365-0295",
            "fax_number": "843-365-0354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2367B Cypress Cir",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268921",
            "country_code": "US",
            "telephone_number": "843-349-1001",
            "fax_number": "843-349-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANJUM",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-18",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NN1397",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.