Active NPI
Plastic Surgery Consultants, LLC
- Specialist
- Columbia, SC
National Provider Identifier
1245319094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 19438
- Legal business name
- PLASTIC SURGERY CONSULTANTS, LLC
- Practice address
- 1220 Blanding St
Columbia, SC 29201-2816 - Phone
- (803) 779-1200
- Fax
- (803) 779-1220
- NPI assigned
- Nov 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard J Wassermann, M.D., MPH, FACS
- Title
- Medical Director
- Phone
- (803) 779-1200
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 19438 | SC | Primary |
Addresses
Primary practice location
1220 Blanding St
Columbia, SC 29201-2816
Mailing address
1220 Blanding St
Columbia, SC 29201-2816
Phone (803) 779-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP3494 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- Columbia, SC
- NPI 1336191931
-
- Plastic and Reconstructive Surgery Physician
- West Columbia, SC
- NPI 1326425059
Single Specialty
-
- Physician Assistant
- Columbia, SC
- NPI 1033735204
-
- Adult Health Nurse Practitioner
- Columbia, SC
- NPI 1801144134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1318377600000",
"number": "1245319094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012816",
"telephone_number": "803-779-1200",
"fax_number": "803-779-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012816",
"telephone_number": "803-779-1200",
"fax_number": "803-779-1220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLASTIC SURGERY CONSULTANTS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-03",
"last_updated": "2011-10-12",
"status": "A",
"authorized_official_last_name": "WASSERMANN",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "803-779-1200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D., MPH, FACS"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "SC",
"license": "19438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3494",
"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 Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.