Individual provider Active NPI

Jimmy Pacheco-Perez, M.D.

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1487670238
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15445 Issued in SC
Practice address
115 Atrium Way Ste 221
Columbia, SC 29223-6383
Phone
(843) 501-1099
Fax
(843) 405-2040
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 15445 SC Primary

Addresses

Primary practice location

115 Atrium Way Ste 221
Columbia, SC 29223-6383

Mailing address

115 Atrium Way Ste 221
Columbia, SC 29223-6383
Phone (843) 501-1099

Other identifiers 2

IdentifierTypeStateIssuer
16770121OtherCAQH
154451MedicaidSC

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
I20110128000351 SC Practitioner - Psychiatry 8123207727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ponce School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

115 Atrium Way
Suite 221
Columbia, SC 29223-6383
Phone (843) 501-1099

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15445SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 1, 1992 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry CurrentSince Oct 1, 1992 Accepting new patients

Locations

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

1800 Colonial Dr
Columbia, SC 29203
Phone (803) 898-0123

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1487670238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "843-501-1099",
            "fax_number": "843-405-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "843-501-1099",
            "fax_number": "843-405-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO-PEREZ",
        "first_name": "JIMMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "15445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16770121",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154451",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.