Active NPI
Mallory Bunton Anderson, FNP-BC
- Nurse Practitioner
- West Columbia, SC
National Provider Identifier
1104166255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 18187
- Practice address
- 131 Summerplace Dr
West Columbia, SC 29169-3058 - Phone
- (803) 794-4585
- Fax
- (803) 796-8924
- NPI assigned
- Feb 27, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18187 | SC | Primary |
Addresses
Primary practice location
131 Summerplace Dr
West Columbia, SC 29169-3058
Mailing address
131 Summerplace Dr
West Columbia, SC 29169-3058
Phone (803) 794-4585
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180425000297 | SC | Practitioner - Nurse Practitioner | 0446513527 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of South Carolina School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Consultants in Gastroenterology PA
Practice addresses (Care Compare)
131 Summerplace Dr
West Columbia, SC 29169-3058
Phone (803) 794-4585
Hospital & facility affiliations
- Lexington Medical Center
- Prisma Health Richland Hospital
- Kershawhealth
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18187 | SC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Consultants in Gastroenterology PA | Current | Accepting new patients |
Locations
11 Gateway Corners Park
Columbia, SC 29203
Phone (803) 462-2300
131 Summerplace Dr
West Columbia, SC 29169
Phone (803) 794-4585
Organizations & group practices 1
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.
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Camden, SC
- NPI 1487220307
Hospital
-
- Geriatric Medicine (Internal Medicine) Physician
- Columbia, SC
- NPI 1962471946
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1104166255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 SUMMERPLACE DR",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693058",
"telephone_number": "803-794-4585",
"fax_number": "803-796-8924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 SUMMERPLACE DR",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693058",
"telephone_number": "803-794-4585",
"fax_number": "803-796-8924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MALLORY",
"middle_name": "BUNTON",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-27",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "18187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.