Mark D Roberts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28818 Issued in SC

Practice address

2845 E Highway 76
Suite 4
Mullins, SC 29574-6037

Phone

(843) 431-2720

Fax

(843) 431-2726

NPI assigned

Jul 27, 2006

Last updated

Oct 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrober16@yourcarecommunity.org
• Direct secure messaging: mroberts253763@direct.musc.edu

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.

• Medical University Hospital Authority

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
  • NPI 1255305876
  Medicare reassignment NPD
• Medical University Hospital Authority

  • Rural Health Clinic/Center
  • Mullins, SC
  • NPI 1043837669
  NPD
• Medical University Hospital Authority

  • Children's Rehabilitation Hospital
  • Charleston, SC
  • NPI 1659101277
  NPD
• Marion Regional Healthcare System

  dba Marion Pediatrics

  • Rural Health Clinic/Center
  • Mullins, SC
  • NPI 1265466585
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1871507913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 E HIGHWAY 76",
            "address_2": "SUITE 4",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2720",
            "fax_number": "843-431-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 E HIGHWAY 76",
            "address_2": "SUITE 4",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746037",
            "telephone_number": "843-431-2720",
            "fax_number": "843-431-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "28818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC538",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288183",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0861",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP5462",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroberts253763@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 E Highway 76",
            "address_2": "Suite 4",
            "city": "Mullins",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295746037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vege R Rao, M.D.
• Michael Edward Raymo, NP
• Stephen P Regec, MD
• Jureall Richburg
• Kristan Roberts
• Shirley Howell Rogers, PHYSICIAN
• Tammy Rogers
• Rosanne J Hooks MD PA (Independent Physicians Group)
• Rosanne J Hooks MD PA (Independent Physicians Group)
• Curtis Rush, RRT

• Pediatrics Physician in Mullins, SC
• Providers in Mullins, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.