Individual provider Active NPI

Mary Kristin Marcum, PT, DPT

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1578913893
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7863 Issued in SC
Practice address
930 Folly Rd Ste B
Charleston, SC 29412-3938
Phone
(843) 314-5434
Fax
(843) 277-6237
NPI assigned
Jun 17, 2016
Last updated
Jun 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7863 SC Primary

Addresses

Primary practice location

930 Folly Rd Ste B
Charleston, SC 29412-3938

Mailing address

930 Folly Rd Ste B
Charleston, SC 29412-3938
Phone (843) 314-5434

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

State licenses

LicenseStateTypeSpecialty
7863SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1578913893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FOLLY RD STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123938",
            "telephone_number": "843-314-5434",
            "fax_number": "843-277-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 FOLLY RD STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123938",
            "telephone_number": "843-314-5434",
            "fax_number": "843-277-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "MARY",
        "middle_name": "KRISTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.