Individual provider Active NPI

Marcus Allen Bethurem, D.O.

  • Child & Adolescent Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1730538869
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
39361 Issued in SC
Practice address
11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone
(803) 434-4300
Fax
(803) 434-4351
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 39361 SC Primary

Addresses

Primary practice location

11 Richland Medical Park Dr
Columbia, SC 29203-6863

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

15 Medical Park Ste 141
General Psychiatry Department
Columbia, SC 29203
Phone (803) 434-1433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210916003454 SC Practitioner - Psychiatry 7618374695 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rocky Vista University College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-4506

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39361SCMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Psychiatry Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Aug 14, 2023 Accepting new patients
Three Rivers Behavioral Health LLC CurrentSince Jul 26, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Aug 14, 2023 Accepting new patients
Mental Illness Recovery Center CurrentSince Sep 16, 2024 Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Locations

2750 Laurel St
Ste 303
Columbia, SC 29204
Phone (803) 252-1953

2750 Laurel St
Columbia, SC 29204
Phone (803) 939-2642

11 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-4506

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

2900 Sunset Blvd
West Columbia, SC 29169
Phone (803) 744-3206

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7878c7ba-d1a3-4bd2-9b45-7234d7142c12/
  • Direct secure messaging: mbethurem377089@direct.ghs.myhfn.org

Organizations & group practices 8

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1730538869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Medical Park Ste 141",
            "address_2": "General Psychiatry Department",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-1433",
            "fax_number": "803-434-4062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHUREM",
        "first_name": "MARCUS",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "39361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.