NPIMap

Individual provider Active NPI

Nzisa L Mutinga, MD

  • Nephrology Physician
  • Columbia, SC
National Provider Identifier
1104891837
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
27589 Issued in SC
Practice address
121 Park Central Dr
200
Columbia, SC 29203-6469
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 27589 SC Primary

Addresses

Primary practice location

121 Park Central Dr
200
Columbia, SC 29203-6469

Mailing address

121 Park Central Dr
200
Columbia, SC 29203-6469
Phone (803) 252-9907

Other identifiers 1

IdentifierTypeStateIssuer
275892MedicaidSC

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
I20050509000214 SC Practitioner - NephrologyPractitioner - Internal Medicine 3779523840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Nephrology Associates PAGroup PAC ID 9537128533, 33 clinicians

Practice addresses (Care Compare)

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 726-2399

Hospital & facility affiliations

  • Fresenius Medical Care North Star Dialysis Dialysis facility, Columbia, SC, CCN 422651
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA CurrentSince Aug 1, 2005 Accepting new patients
Columbia Nephrology Associates PA Nephrology CurrentSince Aug 1, 2005 Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

Interoperability endpoints

  • Direct secure messaging: nzisamutinga@cna.allscriptsdirect.net
  • Direct secure messaging: nmutinga380503@direct.musc.edu

Organizations & group practices 2

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1104891837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036469",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036469",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTINGA",
        "first_name": "NZISA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "27589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275892",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.