Individual provider Active NPI

Dara Anita Josiah-Howze, MD

  • Child & Adolescent Psychiatry Physician
  • Fort Mill, SC
National Provider Identifier
1063407278
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
31489 Issued in SC
Practice address
111 Clebourne St
Suite 110
Fort Mill, SC 29715
Phone
(803) 802-1301
Fax
(803) 802-1303
NPI assigned
Sep 14, 2005
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 9901214 NC
Child & Adolescent Psychiatry Physician 2084P0804X 01052673A IN
Child & Adolescent Psychiatry Physician 2084P0804X 31489 SC Primary

Addresses

Primary practice location

111 Clebourne St
Suite 110
Fort Mill, SC 29715

Mailing address

111 Clebourne St
Suite 110
Fort Mill, SC 29715-1758
Phone (803) 802-1301

Other identifiers 1

IdentifierTypeStateIssuer
314895MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050919000828 IN Practitioner - Psychiatry 3577597699 Reassigns benefits to 1 organization
I20210514000270 IL Practitioner - Psychiatry 3577597699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Brody School of Medicine at East Carolina University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians
Brentwood Meadows Physician Group LLCGroup PAC ID 9830412956, 10 clinicians

Practice addresses (Care Compare)

444 N Pleasant Ave
Centralia, IL 62801-3006
Phone (618) 436-5665

4488 Roslin Rd
Newburgh, IN 47630-8590
Phone (812) 858-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31489SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brentwood Meadows Physician Group LLC CurrentSince Jul 10, 2024 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Nov 15, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2021 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2021 Accepting new patients
St Margaret Mercy Healthcare Centers Inc Past Accepting new patients
Major Hospital Past Accepting new patients
Franciscan Health Dyer & Hammond Past Accepting new patients
Wabash Valley Urological Assoc Inc Past Accepting new patients
Southwest Medical and Psychiatric Services Past Accepting new patients
Little Company of Mary Affiliated Services Inc Past Accepting new patients

Locations

444 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5665

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

4488 Roslin Rd
Newburgh, IN 47630
Phone (812) 710-4038

4801 Olympia Park Plz
Ste 1000
Louisville, KY 40241

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Organizations & group practices 12

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

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1063407278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLEBOURNE ST",
            "address_2": "SUITE 110",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297151758",
            "telephone_number": "803-802-1301",
            "fax_number": "803-802-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CLEBOURNE ST",
            "address_2": "SUITE 110",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29715",
            "telephone_number": "803-802-1301",
            "fax_number": "803-802-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSIAH-HOWZE",
        "first_name": "DARA",
        "middle_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "9901214",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01052673A",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "31489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314895",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.