Active NPI
Jessica Wanthal, MD
- Emergency Medicine Physician
- Columbia, SC
National Provider Identifier
1174175491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 88176
- Practice address
- 14 Richland Medical Park Dr
Columbia, SC 29203-6877 - Phone
- (803) 434-1663
- Fax
- (803) 434-3894
- NPI assigned
- Jul 16, 2019
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 88176 | SC | Primary |
Addresses
Primary practice location
14 Richland Medical Park Dr
Columbia, SC 29203-6877
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of South Carolina School of Medicine, Greenville, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111
Hospital & facility affiliations
- Duke University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke Health Integrated Practice, Inc. | Current | Accepting new patients |
Locations
2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289
40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588
Organizations & group practices 1
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.
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Raleigh, NC
- NPI 1205225646
-
- Rehabilitation Hospital Unit
- Durham, NC
- NPI 1538166061
-
- General Acute Care Hospital
- Durham, NC
- NPI 1992703540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1174175491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 RICHLAND MEDICAL PARK DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036877",
"telephone_number": "803-434-1663",
"fax_number": "803-434-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANTHAL",
"first_name": "JESSICA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-16",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "88176",
"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 Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.