Organization Active NPI

Midland Ear Nose and Throat

  • Otolaryngology Physician
  • Columbia, SC
National Provider Identifier
1366528697
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
00351491 Issued in SC
Legal business name
MIDLAND EAR NOSE AND THROAT
Practice address
3 Richland Medical Park
Suite 130
Columbia, SC 29203-6850
Phone
(803) 744-7770
Fax
(803) 744-7776
NPI assigned
Oct 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Alan Brill, MDNPI 1033182399
Title
President of Midland ENT
Phone
(803) 744-7770

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)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X 00351491 SC Primary

Addresses

Primary practice location

3 Richland Medical Park
Suite 130
Columbia, SC 29203-6850

Mailing address

3 Richland Medical Park
Suite 130
Columbia, SC 29203-6850
Phone (803) 744-7770

Other identifiers 1

IdentifierTypeStateIssuer
PC2644MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050214000613 SC Part B Supplier - Clinic/Group Practice 3375595747 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1366528697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK",
            "address_2": "SUITE 130",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036850",
            "telephone_number": "803-744-7770",
            "fax_number": "803-744-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK",
            "address_2": "SUITE 130",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036850",
            "telephone_number": "803-744-7770",
            "fax_number": "803-744-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND EAR NOSE AND THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "BRILL",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT OF MIDLAND ENT",
        "authorized_official_telephone_number": "803-744-7770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "00351491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2644",
            "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 Dec 3, 2007; 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.

Verify at the official NPI Registry.