Mary Lee Addis, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN 138 Issued in SC

Practice address

1111 Mill St
Camden, SC 29020-3763

Phone

(803) 425-1330

Fax

(803) 425-0324

NPI assigned

Jul 21, 2006

Last updated

Mar 20, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Sandhills Medical Foundation

  • Federally Qualified Health Center (FQHC)
  • McBee, SC
  • NPI 1780640623
  NPD (past)
• Sandhills Medical Foundation, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lugoff, SC
  • NPI 1487712923
  NPD (past)
• Sandhills Medical Foundation, Inc.

  dba Sandhills Medical Foundation- Pageland

  • Federally Qualified Health Center (FQHC)
  • Pageland, SC
  • NPI 1780398461
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1780604579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7003",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290217003",
            "telephone_number": "803-425-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MILL ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203763",
            "telephone_number": "803-425-1330",
            "fax_number": "803-425-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN 138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alycia Strickland Abdulla, FNP-BC
• Henry Matthew Adams
• Shana Watkins Adams
• Jennifer Adkins, PHARMD
• Advance Medical Academy LLC
• Advanced in Home Care LLC (Right at Home)
• Aftercare Home Medical Equipment, Inc (Aftercare Medical Equipment and Supplies)
• Agape Medical Solutions LLC (Agape Medical Billing Services)

• Family Nurse Practitioner in Camden, SC
• Providers in Camden, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.