Active NPI
Marvin Hevener, MD
- Family Medicine Physician
- Cowpens, SC
National Provider Identifier
1639123441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 7842
- Practice address
- 5470 N. Main Street
Cowpens, SC 29330 - Phone
- (864) 463-3286
- Fax
- (864) 463-9258
- NPI assigned
- May 19, 2006
- Last updated
- Sep 24, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 7842 | SC | Primary |
Addresses
Primary practice location
5470 N. Main Street
Cowpens, SC 29330
Mailing address
PO Box 277827
Atlanta, GA 30384-7827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078427 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7842 | SC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Black Physicians Group LLC | Family Medicine | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Spartanburg, SC
- NPI 1295823045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222214400000",
"number": "1639123441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 277827",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303847827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5470 N. MAIN STREET",
"city": "COWPENS",
"state": "SC",
"postal_code": "29330",
"telephone_number": "864-463-3286",
"fax_number": "864-463-9258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEVENER",
"first_name": "MARVIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2008-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "7842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "078427",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cowpens, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.