Individual provider Active NPI

Mary Caitlin St Clair, D. O

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1699137745
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0062996 Issued in CO
Practice address
4200 E North St Ste 16
Greenville, SC 29615-2437
Phone
(864) 794-4944
Fax
(864) 900-5623
NPI assigned
Mar 27, 2016
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0062996 CO Primary

Addresses

Primary practice location

4200 E North St Ste 16
Greenville, SC 29615-2437

Mailing address

4200 E North St Ste 16
Greenville, SC 29615-2437
Phone (864) 794-4944

Other identifiers 1

IdentifierTypeStateIssuer
836234MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190919002791 CO Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 0345597696 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pinon Family Practice LLP Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Nutrition Center of Colorado, LLC PastSince Aug 1, 2019 Accepting new patients

Locations

9895 W Remington Pl
Littleton, CO 80128
Phone (303) 948-2676

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1699137745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 E NORTH ST STE 16",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152437",
            "telephone_number": "864-794-4944",
            "fax_number": "864-900-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E NORTH ST STE 16",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152437",
            "telephone_number": "864-794-4944",
            "fax_number": "864-900-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST CLAIR",
        "first_name": "MARY",
        "middle_name": "CAITLIN",
        "credential": "D. O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-27",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0062996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "836234",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.