Active NPI
Maranda Brown Davis, HAIRLOSS SPECIALIST
- Prosthetics Case Management
- Columbia, SC
National Provider Identifier
1104368968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 1744P3200X
- Practice address
- 2757 Laurel St
3
Columbia, SC 29204-2037 - Phone
- (803) 730-0231
- NPI assigned
- Nov 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 1744P3200X | SC | Primary |
Addresses
Primary practice location
2757 Laurel St
3
Columbia, SC 29204-2037
Mailing address
2757 Laurel St
3
Columbia, SC 29204-2037
Phone (803) 730-0231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1744P3200X | Other | SC | HAIRLOSS SPECIALIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1744P3200X | SC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1104368968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2757 LAUREL ST",
"address_2": "3",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042037",
"telephone_number": "803-730-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2757 LAUREL ST",
"address_2": "3",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292042037",
"telephone_number": "803-730-0231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARANDA",
"middle_name": "BROWN",
"credential": "HAIRLOSS SPECIALIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-10",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "SC",
"license": "1744P3200X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAIRLOSS SPECIALIST",
"identifier": "1744P3200X",
"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 Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.