NPIMap

Individual provider Active NPI

Nikita Kumar Theophilus

  • Nephrology Physician
  • Columbia, SC
National Provider Identifier
1376196485
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
91925 Issued in SC
Practice address
121 Park Central Dr Ste 200
Columbia, SC 29203-6476
Phone
(803) 252-9907
NPI assigned
Jul 17, 2019
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 91925 SC Primary

Addresses

Primary practice location

121 Park Central Dr Ste 200
Columbia, SC 29203-6476

Mailing address

121 Park Central Dr Ste 200
Columbia, SC 29203-6476
Phone (803) 252-9907

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
I20240814000654 SC Practitioner - Internal MedicinePractitioner - Nephrology 1456899038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 726-2399

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA CurrentSince Aug 1, 2024 Accepting new patients
Columbia Nephrology Associates PA Nephrology CurrentSince Aug 1, 2024 Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

3630 Sunset Blvd
West Columbia, SC 29169
Phone (803) 779-1420

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1376196485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOPHILUS",
        "first_name": "NIKITA",
        "middle_name": "KUMAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "91925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.