Active NPI
James Gilder Bouknight, M.D.
- Psychiatry Physician
- Columbia, SC
National Provider Identifier
1174584916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 14983
- Practice address
- 3555 Harden Street Ext
15 Medical Park Rd., Suite 141
Columbia, SC 29203-6894 - Phone
- (803) 434-4300
- Fax
- (803) 434-4277
- NPI assigned
- Mar 31, 2006
- Last updated
- Jan 7, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 14983 | SC | Primary |
| Geriatric Psychiatry Physician | 2084P0805X | 14983 | SC |
Addresses
Primary practice location
3555 Harden Street Ext
15 Medical Park Rd., Suite 141
Columbia, SC 29203-6894
Mailing address
3555 Harden Street Ext
15 Medical Park Rd., Suite 300
Columbia, SC 29203-6894
Phone (803) 434-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149832 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14983 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patricia Feigley, MSW | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Marriage & Family Therapist
- Columbia, SC
- NPI 1902028004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420588800000",
"number": "1174584916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 HARDEN STREET EXT",
"address_2": "15 MEDICAL PARK RD., SUITE 300",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036894",
"telephone_number": "803-434-4300",
"fax_number": "803-434-4277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 HARDEN STREET EXT",
"address_2": "15 MEDICAL PARK RD., SUITE 141",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036894",
"telephone_number": "803-434-4300",
"fax_number": "803-434-4277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUKNIGHT",
"first_name": "JAMES",
"middle_name": "GILDER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2015-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "14983",
"primary": true
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "SC",
"license": "14983",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149832",
"state": "SC"
}
],
"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 Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.