Individual provider Active NPI

Joseph Borromeo Villanueva, M.D.

  • Internal Medicine Physician
  • Sumter, SC
National Provider Identifier
1376831982
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36537 Issued in SC
Practice address
649 W Wesmark Blvd
Sumter, SC 29150-1900
Phone
(803) 469-7500
Fax
(803) 469-7521
NPI assigned
Jul 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36537 SC Primary

Addresses

Primary practice location

649 W Wesmark Blvd
Sumter, SC 29150-1900

Mailing address

649 W Wesmark Blvd
Sumter, SC 29150-1900
Phone (803) 469-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140724002382 SC Practitioner - Internal Medicine 9234355371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Loris Seacoast HospitalGroup PAC ID 9133394398, 57 clinicians

Practice addresses (Care Compare)

3655 Mitchell St
Loris, SC 29569-2827
Phone (843) 716-7111

Hospital & facility affiliations

  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36537SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon CurrentSince Jul 31, 2017 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Jul 1, 2017 Accepting new patients
McLeod Health Clarendon Current Accepting new patients
McLeod Health Clarendon CurrentSince Jul 31, 2017 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Jul 1, 2017 Accepting new patients
McLeod Loris Seacoast Hospital Past Accepting new patients

Locations

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

Interoperability endpoints

  • Direct secure messaging: jvillanueva27037@directmcleodehealth.org

Organizations & group practices 6

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1376831982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-469-7500",
            "fax_number": "803-469-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-469-7500",
            "fax_number": "803-469-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JOSEPH",
        "middle_name": "BORROMEO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-17",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "36537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.