NPIMap

Organization Active NPI

Prisma Health Medical Group-Midlands

  • Developmental - Behavioral Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1457848848
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Practice address
9 Richland Medical Park Dr Ste 210
Columbia, SC 29203-6859
Phone
(803) 935-5604
Fax
(803) 434-1920
NPI assigned
Apr 20, 2018
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
James Ellis
Title
Chief Integration Officer
Phone
(803) 545-5048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X NU Primary

Addresses

Primary practice location

9 Richland Medical Park Dr Ste 210
Columbia, SC 29203-6859

Mailing address

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

Other names 1

  • PH Medical Group Midlands Other name

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Health - University of South Carolina Medical Group72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1457848848",
    "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 210",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-935-5604",
            "fax_number": "803-434-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH MEDICAL GROUP-MIDLANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF INTEGRATION OFFICER",
        "authorized_official_telephone_number": "803-545-5048"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PH Medical Group Midlands",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 11, 2020; 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.