Individual provider Active NPI

Prem Patel

  • Student in an Organized Health Care Education/Training Program
  • Columbia, SC
National Provider Identifier
1215677117
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2 Medical Park Rd
Columbia, SC 29203-6808
Phone
(803) 545-5321
NPI assigned
Mar 30, 2022
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Internal Medicine Physician 207R00000X LL88169 SC

Addresses

Primary practice location

2 Medical Park Rd
Columbia, SC 29203-6808

Mailing address

2 Medical Park Rd
Columbia, SC 29203-6808

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
I20220727000292 SC Order and Referring Only - Family PracticePractitioner - Family Practice 1951783794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Internal Medicine PastSince Apr 3, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1215677117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036808",
            "telephone_number": "803-545-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PREM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL88169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.