NPIMap

Individual provider Active NPI

Damon Daniels, MD,MPH

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1235104464
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21823 Issued in SC
Practice address
74 Polo Rd
Columbia, SC 29223-2806
Phone
(803) 865-9655
Fax
(803) 865-9653
NPI assigned
Feb 21, 2006
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21823 SC Primary

Addresses

Primary practice location

74 Polo Rd
Columbia, SC 29223-2806

Mailing address

74 Polo Rd
Columbia, SC 29223-2806
Phone (803) 865-9655

Other identifiers 1

IdentifierTypeStateIssuer
218231MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070719000631 SC Practitioner - Family Practice 2860593910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

74 Polo Rd
Columbia, SC 29223-2806
Phone (803) 865-9655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21823SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Family Medicine, PA Family Medicine CurrentSince Jan 18, 2007 Accepting new patients

Locations

110 Atrium Way
Columbia, SC 29223
Phone (803) 788-1153

114 Gateway Corporate Blvd
Ste 300
Columbia, SC 29203
Phone (803) 254-3278

74 Polo Rd
Columbia, SC 29223
Phone (803) 419-7780

Interoperability endpoints

  • Direct secure messaging: damon.daniels@wfmed.eclinicaldirectplus.com
  • Direct secure messaging: ddaniels412628@direct.ghs.myhfn.org

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1235104464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292232806",
            "telephone_number": "803-865-9655",
            "fax_number": "803-865-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292232806",
            "telephone_number": "803-865-9655",
            "fax_number": "803-865-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "MD,MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218231",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.