MEDOGUN PA (NPI# 1730229683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730229683 |
| Entity Type | Organization |
| Organization Name | MEDOGUN PA |
| Other Organization Name | MEDOGUN PSYCHIATRIC ASSOCIATES |
| Practice Address |
120 Wildewood Park Dr Suite A Columbia SC 29223-4300 |
| Practice Telephone | 8037887882 |
| Mailing Telephone | 8037887882 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. AYODELE ADETOKUNBO OGUNFOWORA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8037887882 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
21075 | SC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| medogun psychiatric associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376683391 | Medogun Pa | Pediatrics | 120 Wildewood Park Dr, Suite B, Columbia, SC 29223-4300 | 2007-02-07 |
| Street Address |
120 WILDEWOOD PARK DR SUITE A |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164487955 | Mojibola Olayinka Solaja | Pediatrics | 120 Wildewood Park Dr, Suite B, Columbia, SC 29223-4300 | 2006-04-18 |
| 1730346057 | Cooper-lewter Consulting LLC | Social Worker | 120 Wildewood Park Dr, Suite A, Columbia, SC 29223-4313 | 2008-05-22 |
| 1376683391 | Medogun Pa | Pediatrics | 120 Wildewood Park Dr, Suite B, Columbia, SC 29223-4300 | 2007-02-07 |
| 1568416238 | Albertina I. Washington-green | Counselor | 120 Wildewood Park Dr, Suite A, Columbia, SC 29223-4313 | 2006-05-19 |
| 1073578506 | Ayodele A Ogunfowora | Psychiatry & Neurology | 120 Wildewood Park Dr, Suite A, Columbia, SC 29223-4300 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1043835879 | Vida Gholami Yousefian | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-08 |
| 1750910857 | Innovative Tms LLC | Psychiatry & Neurology | 9256 Bendix Rd Ste 205, Columbia, MD 21045-1848 | 2020-04-02 |
| 1063061620 | Hopefull Counseling and Psychiatry LLC | Psychiatry & Neurology | 1421 Calhoun St, Columbia, SC 29201-2509 | 2019-09-06 |
| 1750939864 | Brave, LLC | Psychiatry & Neurology | 2100 Forum Blvd Ste C-2, Columbia, MO 65203-5436 | 2019-09-01 |
| 1073171344 | Himangshu Rathinakumar | Psychiatry & Neurology | University of Missouri 1 Hospital Drive Dco67.00, Columbia, MO 65212-0001 | 2019-06-03 |
| 1154988822 | Alliance Psychiatry LLC | Psychiatry & Neurology | 8840 Stanford Blvd Ste 4000, Columbia, MD 21045-5850 | 2019-05-28 |
| 1285194613 | Mind Matters LLC | Psychiatry & Neurology | 3201 S Providence Rd Ste 202, Columbia, MO 65203-3622 | 2019-03-21 |
| 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.