Clarence Stewart Darby, PA PHD

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

440 Issued in SC

Practice address

140 Wildewood Park Dr Ste 107
Columbia, SC 29223-4312

Phone

(803) 722-4988

Fax

(803) 656-8135

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant, Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: clarence.darby.1@30985.direct.athenahealth.com

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.

• Concierge Medical Group LLC

  • Primary Care Clinic/Center
  • Columbia, SC
  • NPI 1811407521
  Medicare reassignment
• Grace Medical Group, LLC

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1346468204
  Medicare reassignment
• Concierge Medical Lab

  • Primary Care Clinic/Center
  • Columbia, SC
  • NPI 1366220758
  NPD (past)
• Southeast Neuropathy & Treatment Center, LLC

  • Pain Clinic/Center
  • Columbia, SC
  • NPI 1396161808
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1073535605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WILDEWOOD PARK DR STE 107",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234312",
            "telephone_number": "803-722-4988",
            "fax_number": "803-656-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WILDEWOOD PARK DR STE 107",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234312",
            "telephone_number": "803-722-4988",
            "fax_number": "803-656-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBY",
        "first_name": "CLARENCE",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "PA PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Max David Danis, RN
• Margaree Falisha Dansby, LMT
• Logan Alissa Danzell, CRNA
• Annette Darby-Rauch, PA
• Angela S Darby, APRN
• Nancy Gordon Darby, MED MAC MFT DOTSAP
• Andrea Lanalle Darden, DSW, LISW-CP
• Kelsey E Darden, NP-C
• Megha Darji
• Olivia Claire Darr, LMSW, MPH

• Medical Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.