Individual provider Active NPI

Marcus Kyle Mauney, RN

  • Emergency Registered Nurse
  • Spartanburg, SC
National Provider Identifier
1952928897
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
249178 Issued in SC
Practice address
101 E Wood St
Spartanburg, SC 29303-3040
Phone
(864) 560-6000
NPI assigned
Jun 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 249178 SC Primary

Addresses

Primary practice location

101 E Wood St
Spartanburg, SC 29303-3040

Mailing address

301 Shoally Ridge Dr
Boiling Springs, SC 29316-5423
Phone (864) 804-8095

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
249178SCMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1952928897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SHOALLY RIDGE DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165423",
            "telephone_number": "864-804-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUNEY",
        "first_name": "MARCUS",
        "middle_name": "KYLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "SC",
            "license": "249178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.