NPIMap

Organization Active NPI

Irmo Medical Center

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1447532635
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25966 Issued in SC
Legal business name
IRMO MEDICAL CENTER
Practice address
120 Van Der Horst Dr
Columbia, SC 29229
Phone
(843) 610-8206
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Dr. John Webb, DC, MBA
Title
Clinical Director
Phone
(843) 610-8206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25966 SC Primary

Addresses

Primary practice location

120 Van Der Horst Dr
Columbia, SC 29229

Mailing address

120 Van Der Horst Dr
Columbia, SC 29229

National Provider Directory

National Provider Directory
Tax ID family
Advantage Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1447532635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VAN DER HORST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VAN DER HORST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29229",
            "telephone_number": "843-610-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRMO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "843-610-8206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "25966",
            "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 Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.