NPIMap

Organization Active NPI

Anderson Skin and Cancer Clinic PA

Doing business as Dermatopathology Consultation Service

  • Dermatopathology Physician
  • Anderson, SC
National Provider Identifier
1639398480
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
16908 Issued in SC
Legal business name
ANDERSON SKIN AND CANCER CLINIC PA
Doing business as
Dermatopathology Consultation Service
Practice address
2022 Cardinal Cir
Anderson, SC 29621-1504
Phone
(864) 224-7577
Fax
(864) 225-5165
NPI assigned
Apr 24, 2007
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Mark Johnson QuartermanNPI 1275685000
Title
Owner
Phone
(864) 224-7577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 16908 SC Primary

Addresses

Primary practice location

2022 Cardinal Cir
Anderson, SC 29621-1504

Mailing address

2022 Cardinal Cir
Anderson, SC 29621-1504
Phone (864) 224-7577

Other practice location 1

106 Municipal Dr
Seneca, SC 29672-6642
Phone (864) 224-7577

Other practice location 2

200 Carwellyn Rd
Abbeville, SC 29620-5532
Phone (864) 224-7577

Other identifiers 9

IdentifierTypeStateIssuer
TL7847MedicaidSC
AA5766OtherSCMC UPIN
PA4496MedicaidSC
SC98802329OtherSCMC PTAN
404271MedicaidSC
3937PAMedicaidSC
2329OtherSCMEDICARE ID
2961MedicaidSC
NP2759MedicaidSC

Other names 1

  • Dermatopathology Consultation Service Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mquarterman@andersonskin.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000508 SC Part B Supplier - Clinic/Group Practice 1254313232 Receives reassigned benefits from 8 practitioners
Practice locations: Anderson, SC; Pendleton, SC; Seneca, SC; Abbeville, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0252740Anderson Skin & Cancer Clinic PA2022 Cardinal Circle, Anderson, SC 29621ComplianceApr 13, 2027
42D1003006Anderson Skin & Cancer Clinic PA106 Municipal Drive, Seneca, SC 29672Provider-performed microscopyOct 7, 2026
42D1065155Anderson Skin & Cancer Clinic200 Carwellyn Road, Abbeville, SC 29620Provider-performed microscopyFeb 22, 2027

National Provider Directory

National Provider Directory

Locations

200 Carwellyn Rd
Abbeville, SC 29620
Phone (803) 224-7577

2022 Cardinal Cir
Anderson, SC 29621
Phone (864) 224-7577

2503 N Main St
Anderson, SC 29621
Phone (803) 224-7577

908 S Mechanic St
Pendleton, SC 29670
Phone (864) 224-7577

106 Municipal Dr
Seneca, SC 29672
Phone (864) 224-7577

Interoperability endpoints

  • Direct secure messaging: mquarterman@andersonskin.emadirect.md

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1639398480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 CARDINAL CIR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211504",
            "telephone_number": "864-224-7577",
            "fax_number": "864-225-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 CARDINAL CIR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211504",
            "telephone_number": "864-224-7577",
            "fax_number": "864-225-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Municipal Dr",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296726642",
            "country_code": "US",
            "telephone_number": "864-224-7577",
            "fax_number": "864-225-5165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Carwellyn Rd",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "SC",
            "postal_code": "296205532",
            "country_code": "US",
            "telephone_number": "864-224-7577",
            "fax_number": "864-225-5165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDERSON SKIN AND CANCER CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "QUARTERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-224-7577"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "SC",
            "license": "16908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL7847",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC UPIN",
            "identifier": "AA5766",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA4496",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PTAN",
            "identifier": "SC98802329",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404271",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3937PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "2329",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2961",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2759",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mquarterman@andersonskin.emadirect.md",
            "affiliation": "N",
            "address_1": "2022 Cardinal Cir",
            "city": "Anderson",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296211504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dermatopathology Consultation Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.