Individual provider Active NPI

Joshua Taylor Thornhill IV, MD

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1013977974
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15588 Issued in SC
Practice address
15 Medical Park Rd
Suite 103
Columbia, SC 29203-8003
Phone
(803) 434-4300
Fax
(803) 434-4351
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 15588 SC Primary

Addresses

Primary practice location

15 Medical Park Rd
Suite 103
Columbia, SC 29203-8003

Mailing address

3555 Harden Street Ext
15 Medical Park 300
Columbia, SC 29203-6894
Phone (803) 545-5017

Other identifiers 1

IdentifierTypeStateIssuer
155888MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000914 SC Practitioner - Psychiatry 2860685989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Eastern Virginia Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

2 Medical Park Rd
Suite 506
Columbia, SC 29203-6876
Phone (803) 540-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15588SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Psychiatry CurrentSince Mar 27, 2017 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 27, 2017 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

Interoperability endpoints

  • Direct secure messaging: jthornhill413819@direct.ghs.myhfn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1013977974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT",
            "address_2": "15 MEDICAL PARK 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-545-5017",
            "fax_number": "803-255-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK RD",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038003",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNHILL",
        "first_name": "JOSHUA",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "15588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155888",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.