Individual provider Active NPI

Maria Regina Vidanes

  • Medical-Surgical Registered Nurse
  • Columbia, SC
National Provider Identifier
1366909053
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
95871 Issued in SC
Practice address
601 Traditions Way
Columbia, SC 29229-7426
Phone
(803) 708-2795
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 95871 SC Primary

Addresses

Primary practice location

601 Traditions Way
Columbia, SC 29229-7426

Mailing address

601 Traditions Way
Columbia, SC 29229-7426
Phone (803) 708-2795

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

LicenseStateTypeSpecialty
95871SCMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1366909053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TRADITIONS WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297426",
            "telephone_number": "803-708-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TRADITIONS WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297426",
            "telephone_number": "803-708-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDANES",
        "first_name": "MARIA",
        "middle_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "SC",
            "license": "95871",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.