NPIMap

Individual provider Active NPI

Malshundria Prophet, MD

  • Hematology & Oncology Physician
  • Columbia, SC
National Provider Identifier
1073658332
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
39676 Issued in SC
Practice address
166 Stoneridge Dr
Columbia, SC 29210-8239
Phone
(803) 461-3049
Fax
(803) 461-3428
NPI assigned
Feb 21, 2007
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL39676 SC
Hematology & Oncology Physician 207RH0003X LL39676 SC
Hematology & Oncology Physician 207RH0003X 39676 SC Primary

Addresses

Primary practice location

166 Stoneridge Dr
Columbia, SC 29210-8239

Mailing address

166 Stoneridge Dr
Columbia, SC 29210-8239
Phone (803) 461-3049

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200220002609 SC Practitioner - Internal Medicine 0244337632 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
South Carolina Oncology Assoc PAGroup PAC ID 6103739024, 18 clinicians

Practice addresses (Care Compare)

1315 Roberts St
Camden, SC 29020-3737
Phone (803) 432-4311

166 Stoneridge Dr
Columbia, SC 29210-8239
Phone (803) 461-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL39676SCMDInternal Medicine Physician
39676SCMDHematology & Oncology Physician
2735SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians of SC, LLC CurrentSince Oct 1, 2019 Accepting new patients
Musc Community Physicians CurrentSince Apr 25, 2023 Accepting new patients
South Carolina Oncology Assoc PA Hematology & Oncology CurrentSince Jul 5, 2022 Accepting new patients
Musc Community Physicians Internal Medicine Current Accepting new patients
Musc Community Physicians Internal Medicine CurrentSince Apr 25, 2023 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

166 Stoneridge Dr
Columbia, SC 29210
Phone (803) 296-5954

Interoperability endpoints

  • Direct secure messaging: mprophet76409@direct.musc.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1073658332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 STONERIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108239",
            "telephone_number": "803-461-3049",
            "fax_number": "803-461-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 STONERIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108239",
            "telephone_number": "803-461-3049",
            "fax_number": "803-461-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPHET",
        "first_name": "MALSHUNDRIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL39676",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "LL39676",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "39676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.