NPIMap

Organization Active NPI

Midlands Orthopaedics and Neurosurgery, PA

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
National Provider Identifier
1366980591
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MIDLANDS ORTHOPAEDICS AND NEUROSURGERY, PA
Practice address
114 Gateway Corporate Blvd
Suite 110
Columbia, SC 29203-9740
Phone
(803) 256-4107
NPI assigned
Feb 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Karen Kimberly Sooter
Title
Credentialing Coordinator
Phone
(803) 256-4107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

114 Gateway Corporate Blvd
Suite 110
Columbia, SC 29203-9740

Mailing address

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

Other identifiers 1

IdentifierTypeStateIssuer
0266040006OtherSCNCS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171010000895 SC DME Supplier - Physician - General Practice 8628963287 Practice locations: Columbia, SC

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1366980591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013520",
            "telephone_number": "803-256-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GATEWAY CORPORATE BLVD",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039740",
            "telephone_number": "803-256-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLANDS ORTHOPAEDICS AND NEUROSURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "SOOTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "803-256-4107"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCS",
            "identifier": "0266040006",
            "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 Jan 19, 2023; 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.