Active NPI
Vida Gholami Yousefian, MD
- Psychiatry Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL84149
- Practice address
- Prisma Health Medical Group Psychiatry
15 Medical Park, Ste 141
Columbia, SC 29203 - Phone
- (803) 434-1433
- Fax
- (803) 434-4062
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL84149 | SC | Primary |
Addresses
Primary practice location
Prisma Health Medical Group Psychiatry
15 Medical Park, Ste 141
Columbia, SC 29203
Mailing address
Prisma Health Medical Group Psychiatry
15 Medical Park, Ste 141
Columbia, SC 29203
Phone (803) 434-1433
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of South Carolina School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2200 Harden St
Columbia, SC 29203-7107
Phone (803) 898-8405
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL84149 | SC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Psychiatry | Current | Accepting new patients |
| South Carolina Dept of Mental Health Accounting Office | Psychiatry | Current | Accepting new patients |
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients |
Locations
7901 Farrow Rd
Columbia, SC 29203
Phone (803) 734-7846
220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662
2200 Harden St
Columbia, SC 29203
Phone (803) 737-5300
2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461
610 Faison Dr
Columbia, SC 29203
Phone (803) 898-8523
Interoperability endpoints
- vyousefian385603@direct.ghs.myhfn.org
Organizations & group practices 3
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.
-
- Psychiatric Hospital
- Anderson, SC
- NPI 1376595041
Psychiatry
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
-
- Psychiatric Hospital
- Columbia, SC
- NPI 1609825264
Psychiatry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1043835879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PRISMA HEALTH MEDICAL GROUP PSYCHIATRY",
"address_2": "15 MEDICAL PARK, STE 141",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-434-1433",
"fax_number": "803-434-4062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PRISMA HEALTH MEDICAL GROUP PSYCHIATRY",
"address_2": "15 MEDICAL PARK, STE 141",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-434-1433",
"fax_number": "803-434-4062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSEFIAN",
"first_name": "VIDA",
"middle_name": "GHOLAMI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "LL84149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.