Mark D Walsh

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MARK D WALSH

Doing business as

5 Star Family Medicine

Practice address

7611 Highway 76
Suite C
Pendleton, SC 29670-9162

Phone

(864) 546-5570

Fax

(864) 546-5571

NPI assigned

Jan 13, 2014

Last updated

Jan 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark D Walsh, MD

Title

M.D. and Ceo

Phone

(864) 653-0163

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 5 STAR FAMILY MEDICINE Doing business as

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1912329889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 HIGHWAY 76",
            "address_2": "SUITE C",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709162",
            "telephone_number": "864-546-5570",
            "fax_number": "864-546-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 HIGHWAY 76",
            "address_2": "SUITE C",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709162",
            "telephone_number": "864-546-5570",
            "fax_number": "864-546-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D WALSH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "M.D. AND CEO",
        "authorized_official_telephone_number": "864-653-0163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20774",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5 STAR FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Namour Lamonica, LPC-A
• Angela Jean Langdale, RN
• Amanda Patricia Leibovitz, PHD, LPC, LMHC, CMPC
• Patrick G Lollis, MD
• Heath Jackson Major, M.S., ATC
• Kristi Walters Martin, R.N., BSN
• Gregory Albert Marzolf, DDS
• Charlene Rae McCall
• Lily Marie McFarland
• Mallory Ann Mercer, LPC-A

• Primary Care Clinic/Center in Pendleton, SC
• Providers in Pendleton, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.