Active NPI
Michael S. Whitaker
- Family Nurse Practitioner
- Columbia, SC
National Provider Identifier
1366569089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 309
- Practice address
- 4500 8TH Division Rd
Columbia, SC 29207-5700 - Phone
- (803) 751-9230
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 309 | SC | Primary |
Addresses
Primary practice location
4500 8TH Division Rd
Columbia, SC 29207-5700
Mailing address
424 Kettering CT
Columbia, SC 29210-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 309 | Other | SC | SC NURSING LICENSE FOR ADVANCED PRACTICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309 | SC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1366569089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 KETTERING CT",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292104200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 8TH DIVISION RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-9230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "MICHAEL",
"middle_name": "S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2025-07-21",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "309",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC NURSING LICENSE FOR ADVANCED PRACTICE",
"identifier": "309",
"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 Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.