Active NPI
Aly Bise
- Neonatal Nurse Practitioner
- Columbia, SC
National Provider Identifier
1104577600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 25878
- Practice address
- 5 Richland Medical Park Dr
Columbia, SC 29203-6863 - Phone
- (803) 434-7151
- NPI assigned
- Jan 16, 2022
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 25878 | SC | Primary |
Addresses
Primary practice location
5 Richland Medical Park Dr
Columbia, SC 29203-6863
Mailing address
104 Creek Vista Way
Columbia, SC 29206-3153
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 |
|---|---|---|---|
| 25878 | SC | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1104577600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 CREEK VISTA WAY",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292063153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 RICHLAND MEDICAL PARK DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036863",
"telephone_number": "803-434-7151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISE",
"first_name": "ALY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-16",
"last_updated": "2022-03-07",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "SC",
"license": "25878",
"primary": true
}
],
"identifiers": [],
"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 Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.