Individual provider Active NPI

Alice Rose Bruce

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1386218832
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL86107 Issued in SC
Practice address
Prisma Health Medical Group Psychiatry Center
15 Medical Park, Suite 141
Columbia, SC 29203
Phone
(803) 434-4300
Fax
(803) 434-4062
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL86107 SC Primary

Addresses

Primary practice location

Prisma Health Medical Group Psychiatry Center
15 Medical Park, Suite 141
Columbia, SC 29203

Mailing address

Prisma Health Medical Group Psychiatry Center
15 Medical Park, Suite 141
Columbia, SC 29203
Phone (803) 434-4300

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
I20210809003308 SC Order and Referring Only - PsychiatryPractitioner - Psychiatry 6800290107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL86107SCMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: abruce510376@direct.ghs.myhfn.org

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1386218832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH MEDICAL GROUP PSYCHIATRY CENTER",
            "address_2": "15 MEDICAL PARK, SUITE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH MEDICAL GROUP PSYCHIATRY CENTER",
            "address_2": "15 MEDICAL PARK, SUITE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "ALICE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL86107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.