Mildred Louise Martin, RN,MSN,MA,PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Conroy, South Carolina. Her current practice location is
164 Waccamaw Medical Park Dr, Conroy, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 347-4888.
Mildred Louise Martin is licensed to practice in South Carolina (license number 17888APRN) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1942267703.
Provider's Profile
| Full Name | Mildred Louise Martin |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 164 Waccamaw Medical Park Dr, Conroy, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1942267703
- Provider Enumeration Date: 04/27/2006
- Last Update Date: 01/31/2014
Medicare PECOS Information:
- PECOS PAC ID: 1052543071
- Enrollment ID: I20140407000219
Medical Identifiers
Medical identifiers for Mildred Louise Martin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1942267703 | NPI | - | NPPES |
| 327877 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 000720 (Nevada) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 17888APRN (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mildred Louise Martin allows following entities to bill medicare on her behalf.
| Entity Name | South Carolina Dept Of Mental Health Accounting Office |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356397228 PECOS PAC ID: 9032021175 Enrollment ID: O20040303000705 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mildred Louise Martin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mildred Louise Martin, RN,MSN,MA,PMHNP-BC 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 Ph: () - | Mildred Louise Martin, RN,MSN,MA,PMHNP-BC 164 Waccamaw Medical Park Dr, Conroy, SC 29526 Ph: (843) 347-4888 |
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