Individual provider Active NPI

Mariah Barrett, PA-C

  • Dermatology Physician
  • Aiken, SC
National Provider Identifier
1891421079
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4511 Issued in SC
Practice address
1520 Two Notch Rd SE
Aiken, SC 29803-5551
Phone
(803) 649-3909
NPI assigned
Jul 28, 2022
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4511 SC Primary

Addresses

Primary practice location

1520 Two Notch Rd SE
Aiken, SC 29803-5551

Mailing address

104 Shadow LN
Piedmont, SC 29673-8392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220818000552 SC Practitioner - Physician Assistant 6103209523 Reassigns benefits to 2 organizations
I20251218001328 WV Practitioner - Physician Assistant 6103209523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Carolina School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia Dermatology and Skin Surgery CenterGroup PAC ID 7214183136, 6 clinicians

Practice addresses (Care Compare)

4202 Maccorkle Ave SW
Suite 200
S Charleston, WV 25309-1320
Phone (304) 925-7546

Merit-based Incentive Payment System (MIPS)

Final score
83.24 of 100Reported as group
Quality
80.28
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4511SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Dermatology and Skin Surgery Center CurrentSince Dec 1, 2025 Accepting new patients

Locations

3012 Champion Dr
Barboursville, WV 25504
Phone (304) 736-8764

4202 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 925-4761

4202 Maccorkle Ave SW
#200
South Charleston, WV 25309
Phone (304) 925-7546

Interoperability endpoints

  • Direct secure messaging: mariah.barrett@adcs1.emadirect.md

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": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1891421079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SHADOW LN",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296738392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 TWO NOTCH RD SE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035551",
            "telephone_number": "803-649-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "MARIAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "4511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.