NPIMap

Individual provider Active NPI

Naceme Azizzadeh, D.O.

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1306192240
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1613 Issued in SC
Practice address
Taylor at Marion St
Columbia, SC 29220-0001
Phone
(803) 296-3627
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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 1613 SC Primary

Addresses

Primary practice location

Taylor at Marion St
Columbia, SC 29220-0001

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

555 E Cheves St
Florence, SC 29506-2617
Phone (803) 429-4919

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
I20151207003058 SC Practitioner - HospitalistPractitioner - Osteopathic Manipulative Medicine 1052611480 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

Taylor at Marion St
Columbia, SC 29220-0001
Phone (803) 296-5579

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1613SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Jul 1, 2018 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc. Family Medicine CurrentSince Sep 15, 2015 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Current Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2015 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine Current Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

14 Richland Medical Park Dr
Ste 320
Columbia, SC 29203
Phone (803) 434-1663

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

144 N Ravenel St
Florence, SC 29506
Phone (843) 777-2566

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

Interoperability endpoints

  • Direct secure messaging: nazizzadeh376580@direct.ghs.myhfn.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1306192240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TAYLOR AT MARION ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292200001",
            "telephone_number": "803-296-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 E Cheves St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295062617",
            "country_code": "US",
            "telephone_number": "803-429-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZIZZADEH",
        "first_name": "NACEME",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "1613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.