Individual provider Active NPI

Jennifer Gregory Amrol, MD

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1174559553
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23847 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 400
Columbia, SC 29203-6878
Phone
(803) 434-7950
Fax
(803) 434-8606
NPI assigned
Jun 25, 2006
Last updated
Apr 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23847 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 400
Columbia, SC 29203-6878

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
T80463MedicaidSC

Other names 1

  • Dr. Jennifer Gregory Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405000360 SC Practitioner - Pediatric Medicine 7012964752 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23847SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Pediatrics CurrentSince Sep 23, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 23, 2016 Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 400
Columbia, SC 29203
Phone (803) 434-7945

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

9 Richland Medical Park Dr
Ste 300
Columbia, SC 29203
Phone (718) 818-2419

Interoperability endpoints

  • Direct secure messaging: jamrol376587@direct.ghs.myhfn.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1174559553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036878",
            "telephone_number": "803-434-7950",
            "fax_number": "803-434-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMROL",
        "first_name": "JENNIFER",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "23847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T80463",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GREGORY",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.