Active NPI
Marissa Hartert
- Pharmacist
- Columbia, SC
National Provider Identifier
1942819602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 42595
- Practice address
- 3312 Devine St
Columbia, SC 29205-1850 - Phone
- (803) 748-8858
- NPI assigned
- Jul 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30084 | NC | |
| Pharmacist | 183500000X | 42595 | SC | Primary |
Addresses
Primary practice location
3312 Devine St
Columbia, SC 29205-1850
Mailing address
3312 Devine St
Columbia, SC 29205-1850
Phone (704) 661-0923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42595 | Other | SC | PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30084 | NC | MD | Pharmacist |
| 42595 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1942819602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3312 DEVINE ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292051850",
"telephone_number": "704-661-0923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3312 DEVINE ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292051850",
"telephone_number": "803-748-8858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTERT",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "30084",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "42595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "42595",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.