NPIMap

Individual provider Active NPI

Prima Dorothy Ray, PA-C

  • Medical Physician Assistant
  • Columbia, SC
National Provider Identifier
1083270912
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3224 Issued in SC
Practice address
109 Barton Creek CT
Columbia, SC 29229-8027
Phone
(803) 256-2286
Fax
(803) 419-8430
NPI assigned
May 16, 2019
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TL3224 SC
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X 3224 SC Primary

Addresses

Primary practice location

109 Barton Creek CT
Columbia, SC 29229-8027

Mailing address

109 Barton Creek CT
Columbia, SC 29229-8027
Phone (803) 256-2286

Other identifiers 1

IdentifierTypeStateIssuer
3224OtherSCPA LICENSE

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
I20191001003250 SC Practitioner - Physician Assistant 6709116973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

109 Barton Creek CT
Columbia, SC 29229-8027
Phone (803) 256-2286

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3224SCMDOccupational Therapist
TL3224SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Mar 1, 2021 Accepting new patients
Lexington Health Inc CurrentSince Mar 1, 2021 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

109 Barton Creek Ct
Columbia, SC 29229
Phone (803) 256-2286

109 Barton Creek Ct
Ste A
Columbia, SC 29229
Phone (803) 791-2683

3016 Longtown Commons Dr
Ste 205
Columbia, SC 29229
Phone (803) 739-3660

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

Interoperability endpoints

  • Direct secure messaging: pray92939@direct.lexmed.com

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1083270912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BARTON CREEK CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298027",
            "telephone_number": "803-256-2286",
            "fax_number": "803-419-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BARTON CREEK CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298027",
            "telephone_number": "803-256-2286",
            "fax_number": "803-419-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "PRIMA",
        "middle_name": "DOROTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL3224",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "3224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "3224",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.