ENVISION WELLNESS MEDICAL GROUP LLC (NPI# 1043832157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043832157 |
| Entity Type | Organization |
| Organization Name | ENVISION WELLNESS MEDICAL GROUP LLC |
| Practice Address |
4100 N Main St Ste 101 Columbia SC 29203-5800 |
| Practice Telephone | 8032560101 |
| Practice Fax Number | 8008543497 |
| Mailing Telephone | 8032560101 |
| Mailing Fax Number | 8008543497 |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | AYANNA SWINTON JAMISON (DR/OWNER) |
| Authorized Official Telephone | 8032560101 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
4100 N MAIN ST STE 101 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548664964 | Melody Ann Boling | Psychiatry & Neurology | 1 Hospital Dr # Dc067.00, Department of Psychiatry, Columbia, MO 65212-1000 | 2014-10-14 |
| 1548502362 | Dina Marie Sztein | Psychiatry & Neurology | 9841 Broken Land Pkwy Ste 211, Columbia, MD 21046 | 2013-03-19 |
| 1568736247 | David Downie Iv, M.d.,p.a. | Psychiatry & Neurology | 1327 Richland Street, Columbia, SC 29201 | 2012-02-28 |
| 1447522800 | Life Strategies LLC | Psychiatry & Neurology | 2855 Pruitt Dr, Columbia, SC 29204-3645 | 2012-02-01 |
| 1699938217 | Anita Bajaj | Psychiatry & Neurology | 10015 Old Columbia Rd # L26d, Columbia, MD 21046-1703 | 2008-07-03 |
| 1306024930 | Kimberly C Walker | Psychiatry & Neurology | 10630 Little Patuxent Pkwy Ste 313, Columbia, MD 21044-6216 | 2008-02-06 |
| 1043308356 | Herbert Randolph Spencer | Psychiatry & Neurology | 1800 Colonial Drive, Columbia, SC 29201 | 2006-10-11 |
| 1891883005 | Elizabeth Hubbard Jeffords | Psychiatry & Neurology | 3612 Landmark Dr Ste B, Columbia, SC 29204-4039 | 2006-10-11 |
| 1134231723 | Judith Victoria Ovalle Abuabara | Psychiatry & Neurology | 106 Corporate Lake Dr, Columbia, MO 65203-7170 | 2006-08-31 |
| 1316989304 | Mark A Riddle | Psychiatry & Neurology | 5500 Knoll North Dr Ste 370, Columbia, MD 21045-2393 | 2006-06-12 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.