Active NPI
Alice Rose Bruce
- Psychiatry Physician
- Columbia, SC
National Provider Identifier
1386218832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL86107
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210809003308 | SC | Order and Referring Only - Psychiatry | 6800290107 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL86107 | SC | MD | Psychiatry Physician |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.