Individual provider Active NPI

John Andrew Wassum, MD

  • Forensic Pathology Physician
  • Greenville, SC
National Provider Identifier
1639490915
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Pathology PhysicianTaxonomy code 207ZF0201X
License
32766LL Issued in SC
Practice address
8 Memorial Medical CT Ste 1
Greenville, SC 29605-4400
Phone
(864) 295-3492
Fax
(864) 295-4817
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 32766LL SC
Forensic Pathology Physician 207ZF0201X 32766LL SC Primary

Addresses

Primary practice location

8 Memorial Medical CT Ste 1
Greenville, SC 29605-4400

Mailing address

8 Memorial Medical CT Ste 1
Greenville, SC 29605-4400
Phone (864) 295-3492

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32766LLSCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Greenville PA Anatomic Pathology & Clinical Pathology CurrentSince Nov 16, 2021 Accepting new patients
Pathology Consultants, Inc Forensic Pathology PastSince Nov 16, 2021 Accepting new patients

Locations

8 Memorial Medical Ct
Ste 1
Greenville, SC 29605
Phone (864) 295-3492

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1639490915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT STE 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054400",
            "telephone_number": "864-295-3492",
            "fax_number": "864-295-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT STE 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054400",
            "telephone_number": "864-295-3492",
            "fax_number": "864-295-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSUM",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "32766LL",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "SC",
            "license": "32766LL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.