NPIMap

Organization Active NPI

University Pediatrics

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1083657233
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNIVERSITY PEDIATRICS
Practice address
9 Medical Park
Suite 200a
Columbia, SC 29203-6859
Phone
(803) 434-7950
Fax
(803) 434-8606
NPI assigned
Jun 14, 2006
Last updated
Dec 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Dr. William D. Anderson III, M.D.
Title
Cmo
Phone
(803) 434-7950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

9 Medical Park
Suite 200a
Columbia, SC 29203-6859

Mailing address

15 Medical Park
Suite 300
Columbia, SC 29203-6843
Phone (803) 545-5022

Other identifiers 2

IdentifierTypeStateIssuer
DEC100MedicaidSC
GP0219MedicaidSC

National Provider Directory

National Provider Directory

Locations

4 Medical Park Rd
Ste 301
Columbia, SC 29203

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1083657233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036843",
            "telephone_number": "803-545-5022",
            "fax_number": "803-256-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PARK",
            "address_2": "SUITE 200A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-7950",
            "fax_number": "803-434-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "803-434-7950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DEC100",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0219",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.