PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP (NPI# 1083101471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083101471 |
| Entity Type | Organization |
| Organization Name | PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP |
| Practice Address |
300 Palmetto Health Pkwy Ste 300 Columbia SC 29212-1763 |
| Mailing Address |
Po Box 743904 Atlanta GA 30374-3904 |
| Practice Telephone | 8039077300 |
| Practice Fax Number | 8039077309 |
| Mailing Telephone | 8032967320 |
| Mailing Fax Number | 8032967330 |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-04-20 |
| Authorized Official Name | WILLIAM D. ANDERSON III, (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 8035455226 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245720747 | Palmetto Health - University of South Carolina Medical Group | Urology | 9 Richland Medical Park Dr Ste 420, Columbia, SC 29203-6870 | 2018-05-10 |
| 1295224871 | Palmetto Health - University of South Carolina Medical Group | Nurse Practitioner | 2113 Adams Grv Ste 200, Columbia, SC 29203-6957 | 2018-05-09 |
| 1235614462 | Palmetto Health - University of South Carolina Medical Group | Family Medicine | 116 Hospital Sq, Bishopville, SC 29010-7081 | 2018-10-03 |
| 1295211894 | Palmetto Health - University of South Carolina Medical Group | Family Medicine | 115 N Sumter St Ste 315, Sumter, SC 29150-4967 | 2018-07-17 |
| 1619468774 | Palmetto Health - University of South Carolina Medical Group | Surgery | 1850 Laurel St, Columbia, SC 29201-2627 | 2018-05-24 |
| 1164913224 | Palmetto Health - University of South Carolina Medical Group | Internal Medicine | 3 Richland Medical Park Dr Ste 510, Columbia, SC 29203-6854 | 2018-05-24 |
| 1437649936 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 14 Richland Medical Park Dr Ste 400, Columbia, SC 29203-6878 | 2018-05-10 |
| 1154811651 | Palmetto Health - University of South Carolina Medical Group | Surgery | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2018-05-10 |
| 1144710641 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 9 Richland Medical Park Drive, Suite 260, Columbia, SC 29203 | 2018-05-10 |
| 1134619638 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 9 Richland Medical Park Dr Ste 230, Columbia, SC 29203-6859 | 2018-05-10 |
| Street Address |
300 PALMETTO HEALTH PKWY STE 300 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29212-1763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225006372 | Jennifer M Risinger | Obstetrics & Gynecology | 300 Palmetto Health Pkwy Ste 300, Columbia, SC 29212-1763 | 2006-03-14 |
| 1417323213 | Mattie Kristen Brazell Julian | Nurse Practitioner | 300 Palmetto Health Pkwy Ste 300, Columbia, SC 29212-1763 | 2015-08-15 |
| 1588046411 | Lawren Evelyn Honken | Obstetrics & Gynecology | 300 Palmetto Health Pkwy Ste 300, Columbia, SC 29212-1763 | 2015-06-27 |
| 1790737997 | Albert E Odom Jr. | Obstetrics & Gynecology | 300 Palmetto Health Pkwy Ste 300, Columbia, SC 29212-1763 | 2006-05-16 |
| 1891759916 | Mark David Wild | Obstetrics & Gynecology | 300 Palmetto Health Pkwy Ste 300, Columbia, SC 29212-1763 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245758887 | Amanda Gail Holloman | Pharmacist | 6021 St. Andrews Road, Columbia, SC 29212 | 2017-09-04 |
| 1578080180 | Alvin Mitchell Jr. | Non-emergency Medical Transport (VAN) | 10 Breezewood Court, Columbia, SC 29212 | 2017-08-24 |
| 1467975102 | Shelby Clemmer | Behavior Technician | 2 Harbison Way, Columbia, SC 29212 | 2017-07-25 |
| 1982149019 | Showntellem | Private Vehicle | 336 Foxfire Dr, Columbia, SC 29212 | 2016-12-28 |
| 1902215296 | Miranda Willis Adult Day Care, LLC | Social Worker | 5932 Mcmillian Circle, Columbia, SC 29212 | 2014-08-12 |
| 1013342591 | Robert Glendon Long | Pediatrics | 15 Woodpine Ct, Columbia, SC 29212 | 2013-09-04 |
| 1174969638 | Melinda Dumas Crenshaw | Psychologist | 2800 Ashland Rd., Columbia, SC 29212 | 2013-05-10 |
| 1417209982 | Physician Services LLC | Internal Medicine | 214 Lake Front Drive, Physician Services, Cola, SC 29212 | 2012-10-09 |
| 1306131800 | Rocky Mountain Holdings LLC | Ambulance | 6015 Saint Andrews Rd, Columbia, SC 29212 | 2011-06-13 |
| 1023262839 | Candace Anne Aguiar | Nurse Anesthetist, Certified Registered | 400 Palmetto Health Pkwy, Palmetto Health Baptist Parkridge, Columbia, SC 29212 | 2008-11-06 |
| Find all providers in zip 29212 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750988036 | Lexington Health Inc | Obstetrics & Gynecology | 700 Gervais St Ste 300, Columbia, SC 29201-3061 | 2020-10-08 |
| 1700403334 | Sarah Mai Truong | Obstetrics & Gynecology | 402 N Keene St # Dc570.00, Columbia, MO 65201-6986 | 2020-06-30 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1962049593 | Michael Wayne Mccullough | Obstetrics & Gynecology | 500 N Keene St Ste 400, Columbia, MO 65201-8104 | 2019-12-02 |
| 1144881509 | Stephanie Barata | Obstetrics & Gynecology | 402 N Keene St Ste 402, Columbia, MO 65201-6986 | 2019-06-26 |
| 1407411895 | Silki Pankajkumar Modi | Obstetrics & Gynecology | The Women's Center, 1801 Sunseet Drive, Columbia, SC 29203 | 2019-05-01 |
| 1780105080 | Jennifer Irene Higdon | Obstetrics & Gynecology | Women's Center, 1801 Sunset Drive, Columbia, SC 29203 | 2017-06-28 |
| 1184157984 | Robert Mcdavid | Obstetrics & Gynecology | 3609 Arbor Ct, Columbia, MO 65201-6542 | 2017-04-07 |
| 1831548254 | Darrah Berck | Obstetrics & Gynecology | 1601 E Broadway Ste 300, Columbia, MO 65201-8022 | 2016-06-07 |
| 1285013276 | Whitney Lynn Shepard | Obstetrics & Gynecology | 1228 Harden St Ste B, Columbia, SC 29204-1800 | 2015-05-22 |
| 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.