NPIMap

Individual provider Active NPI

J William Phillips III, MD

  • Interventional Cardiology Physician
  • Columbia, SC
National Provider Identifier
1114926797
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
23595 Issued in SC
Practice address
1655 Bernardin Ave Ste 220
Columbia, SC 29204-2044
Phone
(803) 409-7170
Fax
(803) 409-7175
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 23595 SC
Interventional Cardiology Physician 207RI0011X 23595 SC Primary

Addresses

Primary practice location

1655 Bernardin Ave Ste 220
Columbia, SC 29204-2044

Mailing address

PO Box 935722
Atlanta, GA 31193-5722
Phone (843) 792-6200

Other identifiers 2

IdentifierTypeStateIssuer
23595OtherSCSC LICENSE
235953MedicaidSC

Other names 1

  • Dr. James William Phillips III Professional name

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
I20040405001054 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9830182054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of South Carolina School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1655 Bernardin Ave
Suite 220
Columbia, SC 29204-2044
Phone (803) 409-7170

Hospital & facility affiliations

  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Newberry County Memorial Hospital Hospital, Newberry, SC, CCN 420053

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Midlands CurrentSince Jul 30, 2003 Accepting new patients
Prisma Health-Midlands Current Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Prisma Health-Midlands CurrentSince Jul 30, 2003 Accepting new patients
Musc Community Physicians Interventional Cardiology CurrentSince Aug 1, 2021 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients
Fairfield Memorial Hospital Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

1655 Brabham Ave
Ste 220
Columbia, SC 29204
Phone (803) 254-5038

2041 Medical Park Dr
Newberry, SC 29108
Phone (803) 276-2860

1175 Cook Rd
Ste 230
Orangeburg, SC 29118
Phone (803) 395-3844

Interoperability endpoints

  • Direct secure messaging: jphillips379603@direct.musc.edu

Organizations & group practices 7

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114926797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935722",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935722",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE STE 220",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042044",
            "telephone_number": "803-409-7170",
            "fax_number": "803-409-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "J",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "23595",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SC",
            "license": "23595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE",
            "identifier": "23595",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235953",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "PHILLIPS",
            "middle_name": "WILLIAM",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.