Individual provider Active NPI

Agnieszka Mynarska

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1508617895
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL91520 Issued in SC
Practice address
1301 Taylor St Ste 6J
Columbia, SC 29201-2930
Phone
(803) 434-1433
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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 LL91520 SC Primary

Addresses

Primary practice location

1301 Taylor St Ste 6J
Columbia, SC 29201-2930

Mailing address

1301 Taylor St Ste 6J
Columbia, SC 29201-2930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL91520SCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1508617895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST STE 6J",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST STE 6J",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012930",
            "telephone_number": "803-434-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNARSKA",
        "first_name": "AGNIESZKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL91520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.