Amjad Abdulrahman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21671 Issued in SC

Practice address

7430 College St
Irmo, SC 29063-2903

Phone

(803) 732-4001

Fax

(803) 799-1922

NPI assigned

Aug 29, 2005

Last updated

Jul 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Palmetto Primary Care Physicians, LLC

  dba PPCP Canterbury House

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  Medicare reassignment NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1184190530
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Three Rivers Medical Associates, PA

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1760445597
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1194718841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7430 COLLEGE ST",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632903",
            "telephone_number": "803-732-4001",
            "fax_number": "803-799-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULRAHMAN",
        "first_name": "AMJAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00057303",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216714",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 7210 Irmo Dental, PC (Bela Family Dentistry of Irmo)
• A. Crosby Livingston, Jr., DMD, PA
• Tracey Abercrombie, RN
• Achieve Behavioral Health PA (Vertical Treatment Centers Columbia)
• Achieve DME, Inc.
• Kimberly Michelle Adams, OTR
• Sarah Dale Adams, DPT

• Internal Medicine Physician in Irmo, SC
• Providers in Irmo, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.