Individual provider Active NPI

Alyssa S Cogdill, FNP

  • Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1376863654
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN4253 Issued in SC
Practice address
9 Richland Medical Park Dr Ste 110
Columbia, SC 29203-6859
Phone
(803) 434-7961
Fax
(803) 434-7981
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 204186 SC
Nurse Practitioner 363L00000X APN4253 SC Primary

Addresses

Primary practice location

9 Richland Medical Park Dr Ste 110
Columbia, SC 29203-6859

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other names 1

  • Alyssa S Tober Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000917 SC Practitioner - Nurse Practitioner 1052445467 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4253SCMDSpeech-Language Pathologist
204186SCMDNurse Practitioner
APN4253SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 23, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 23, 2016 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

9 Richland Medical Park Dr
Ste 110
Columbia, SC 29203
Phone (803) 434-7940

Interoperability endpoints

  • Direct secure messaging: acogdill378293@direct.ghs.myhfn.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1376863654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-7961",
            "fax_number": "803-434-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGDILL",
        "first_name": "ALYSSA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "204186",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "APN4253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "TOBER",
            "middle_name": "S",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.