Individual provider Active NPI

Mark A. George, FNP

  • Family Nurse Practitioner
  • Easley, SC
National Provider Identifier
1891176491
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0515447 Issued in SC
Practice address
107 Hamilton CT
Easley, SC 29642-3066
Phone
(864) 477-0204
NPI assigned
Jun 9, 2015
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0515447 SC Primary

Addresses

Primary practice location

107 Hamilton CT
Easley, SC 29642-3066

Mailing address

107 Hamilton CT
Easley, SC 29642-3066
Phone (864) 477-0204

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151102002199 SC Practitioner - Nurse Practitioner 8426368556 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19611SCMDPsychiatry Physician
F0515447SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (SC) PC Current Accepting new patients
Centerwell Senior Primary Care (SC) PC CurrentSince Jun 5, 2017 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

108 Highway 28 Byp
Anderson, SC 29624
Phone (864) 296-5208

3516 Highway 153
Greenville, SC 29611
Phone (864) 729-6626

805 W Wade Hampton Blvd
Ste C
Greer, SC 29650
Phone (864) 655-6615

Organizations & group practices 3

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1891176491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HAMILTON CT",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423066",
            "telephone_number": "864-477-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 HAMILTON CT",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423066",
            "telephone_number": "864-477-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F0515447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.