NPIMap

Individual provider Active NPI

Gregory R Malcolm, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Columbia, SC
National Provider Identifier
1427138528
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
12464 Issued in SC
Practice address
240 Stoneridge Dr
Suite 304
Columbia, SC 29210-8013
Phone
(803) 708-8126
Fax
(803) 708-1370
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 12464 SC
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 12464 SC Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 12464 SC

Addresses

Primary practice location

240 Stoneridge Dr
Suite 304
Columbia, SC 29210-8013

Mailing address

PO Box 3387
Frederick, MD 21705-3387
Phone (888) 276-1910

Other identifiers 6

IdentifierTypeStateIssuer
2001038OtherSCCCP
124644OtherSCSELECT HEALTH
77844OtherSCMEDCOST
050028871OtherSCRR MEDICARE
4130018OtherSCAETNA
124644MedicaidSC

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
I20110303000083 SC Practitioner - Anesthesiology 2466634084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Carolina School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 296-5137

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12464SCMDPharmacist
23834SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Dec 1, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 1, 2020 Accepting new patients
Shenandoah Anesthesia & Research Services , PLLC Anesthesiology Past Accepting new patients
Pain Management, LLC Past Accepting new patients
Gaffney Hma LLC Past Accepting new patients

Locations

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

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 11

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1427138528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3387",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217053387",
            "telephone_number": "888-276-1910",
            "fax_number": "803-708-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 STONERIDGE DR",
            "address_2": "SUITE 304",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108013",
            "telephone_number": "803-708-8126",
            "fax_number": "803-708-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "GREGORY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "12464",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "SC",
            "license": "12464",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "12464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCP",
            "identifier": "2001038",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "124644",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "77844",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050028871",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4130018",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124644",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.