Active NPI
Ralph C Pollock, M.D.
- Psychiatry Physician
- Columbia, SC
National Provider Identifier
1215069034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 28154
- Practice address
- 2715 Colonial Dr # 200B
Columbia, SC 29203-6818 - Phone
- (803) 898-8888
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 28154 | SC | Primary |
Addresses
Primary practice location
2715 Colonial Dr # 200B
Columbia, SC 29203-6818
Mailing address
PO Box 291563
Columbia, SC 29229-0027
Phone (803) 563-8845
Other practice location 1
116 Belle Grove Cir
Columbia, SC 29229-8906
Phone (803) 563-8845
Other practice location 2
125 Alpine Cir
Columbia, SC 29223-6385
Phone (803) 779-3548
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281545 | Medicaid | SC | |
| AA38152603 | Other | SC | MEDICARE PTAN |
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 |
|---|---|---|---|
| 28154 | SC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1215069034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 291563",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292290027",
"telephone_number": "803-563-8845",
"fax_number": "803-526-7631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2715 COLONIAL DR # 200B",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036818",
"telephone_number": "803-898-8888"
}
],
"practiceLocations": [
{
"address_1": "116 Belle Grove Cir",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292298906",
"country_code": "US",
"telephone_number": "803-563-8845",
"fax_number": "803-526-7631",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 Alpine Cir",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292236385",
"country_code": "US",
"telephone_number": "803-779-3548",
"fax_number": "803-779-7055",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLLOCK",
"first_name": "RALPH",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "28154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "281545",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "AA38152603",
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.