NPIMap

Organization Active NPI

Medical Park OB-GYN, PA

  • Specialist
  • Columbia, SC
National Provider Identifier
1114995974
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8080 Issued in SC
Legal business name
MEDICAL PARK OB-GYN, PA
Practice address
9 Medical Park Rd
Suite 400
Columbia, SC 29203-6873
Phone
(803) 254-4110
Fax
(803) 256-3932
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nicole W Popovich
Title
Manager
Phone
(803) 254-4110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 8080 SC Primary

Addresses

Primary practice location

9 Medical Park Rd
Suite 400
Columbia, SC 29203-6873

Mailing address

9 Medical Park Rd
Suite 400
Columbia, SC 29203-6873
Phone (803) 254-4110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114995974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PARK RD",
            "address_2": "SUITE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036873",
            "telephone_number": "803-254-4110",
            "fax_number": "803-256-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PARK RD",
            "address_2": "SUITE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036873",
            "telephone_number": "803-254-4110",
            "fax_number": "803-256-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK OB-GYN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POPOVICH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-254-4110"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "8080",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.