Active NPI
Martine A Hutton, M.D
- Pediatrics Physician
- Charleston, SC
National Provider Identifier
1972804888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 09337
- Practice address
- 776 Daniel Ellis Drive
Suite 3C
Charleston, SC 29412 - Phone
- (843) 795-0900
- Fax
- (843) 762-5495
- NPI assigned
- Nov 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 09337 | SC | Primary |
Addresses
Primary practice location
776 Daniel Ellis Drive
Suite 3C
Charleston, SC 29412
Mailing address
PO Box 12159
Charleston, SC 29412
Phone (843) 795-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP1165 | Medicaid | SC |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09337 | SC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1972804888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12159",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29412",
"telephone_number": "843-795-0900",
"fax_number": "843-762-5495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "776 DANIEL ELLIS DRIVE",
"address_2": "SUITE 3C",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29412",
"telephone_number": "843-795-0900",
"fax_number": "843-762-5495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTON",
"first_name": "MARTINE",
"middle_name": "A",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-09",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "09337",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1165",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.