Individual provider Active NPI

Manoj Kumar Nepal, M.D.

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1063783454
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
85689 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 400
Columbia, SC 29203-6878
Phone
(803) 434-7945
Fax
(803) 434-3855
NPI assigned
Jan 18, 2012
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P8705 TX
Pediatrics Physician 208000000X 85689 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 400
Columbia, SC 29203-6878

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

333 N Santa Rosa St
San Antonio, TX 78207-3108
Phone (210) 704-2608

Other identifiers 4

IdentifierTypeStateIssuer
856899MedicaidSC
MD446172OtherPAPA LICENSE
932038OtherNYSUNY DOWNSTATE MEDICAL CENTER
P8705OtherTXTEXAS MEDICAL LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SC2 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
I20140402000220 TX Practitioner - Pediatric MedicinePractitioner - Hospitalist 7517115835 Reassigns benefits to 2 organizations
I20210827000872 SC Practitioner - Pediatric Medicine 7517115835

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85689SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Pediatrics CurrentSince Feb 3, 2014 Accepting new patients
Texas Children's Physician Group Pediatrics CurrentSince Aug 8, 2023 Accepting new patients
Texas Children's Hospital Past Accepting new patients

Locations

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

1102 Bates Ave
#1450
Houston, TX 77030

315 N San Saba
Ste 1003
San Antonio, TX 78207
Phone (210) 261-3100

315 N San Saba
Ste 1210
San Antonio, TX 78207
Phone (210) 354-0877

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

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, 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": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1063783454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036878",
            "telephone_number": "803-434-7945",
            "fax_number": "803-434-3855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Santa Rosa St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073108",
            "country_code": "US",
            "telephone_number": "210-704-2608",
            "fax_number": "210-704-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEPAL",
        "first_name": "MANOJ",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P8705",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "85689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856899",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "MD446172",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUNY DOWNSTATE MEDICAL CENTER",
            "identifier": "932038",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE NUMBER",
            "identifier": "P8705",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.