NPIMap

Individual provider Active NPI

John Russell Fleming Jr., M.D.

  • Family Medicine Physician
  • Sumter, SC
National Provider Identifier
1366448771
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20821 Issued in SC
Practice address
1229 Alice Dr
Sumter, SC 29150-1970
Phone
(803) 905-2273
Fax
(803) 905-7775
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 20821 SC
Family Medicine Physician 207Q00000X 20821 SC Primary

Addresses

Primary practice location

1229 Alice Dr
Sumter, SC 29150-1970

Mailing address

1035 Foxridge CT
Sumter, SC 29150-1732
Phone (803) 236-9180

Other identifiers 1

IdentifierTypeStateIssuer
T49196MedicaidSC

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
I20031112000637 SC Practitioner - Family Practice 6709799976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1229 Alice Dr
Sumter, SC 29150-1970
Phone (803) 905-2273

Hospital & facility affiliations

  • Caris Healthcare Columbia Hospice, Columbia, SC, CCN 421584
  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20821SCMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Family Practice LLC Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Emergency Physician Specialists Inc Emergency Medicine Past Accepting new patients
Fort Wayne Medical Education Program Family Medicine PastSince Sep 1, 2024 Accepting new patients
Marlboro Emergency Group PC Emergency Medicine Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Fairfield Memorial Hospital Past Accepting new patients

Locations

1229 Alice Dr
Sumter, SC 29150
Phone (803) 905-2273

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIAJBD/Endpoint/CIAJBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CIAJBD

Organizations & group practices 6

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 10

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1366448771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 FOXRIDGE CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501732",
            "telephone_number": "803-236-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 ALICE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501970",
            "telephone_number": "803-905-2273",
            "fax_number": "803-905-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "SC",
            "license": "20821",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "20821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T49196",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.