NPIMap

Individual provider Active NPI

Jason David Dahlberg, M.D.

  • Family Medicine Physician
  • Greenwood, SC
National Provider Identifier
1508800848
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21167 Issued in SC
Practice address
313 Main St
Suite a
Greenwood, SC 29646-2757
Phone
(864) 229-4446
Fax
(864) 229-8037
NPI assigned
Jun 16, 2006
Last updated
Sep 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21167 SC Primary

Addresses

Primary practice location

313 Main St
Suite a
Greenwood, SC 29646-2757

Mailing address

313 Main St
Suite B
Greenwood, SC 29646-2757
Phone (864) 388-0301

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
I20110228000231 SC Practitioner - Family Practice 8729083787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Consultants of GreenwoodGroup PAC ID 8426174210, 2 clinicians
Carolina Health Centers IncGroup PAC ID 5496707804, 30 clinicians

Practice addresses (Care Compare)

109 Lanier Wood Rd
Greenwood, SC 29649-9589
Phone (864) 344-4232

313 Main St
Greenwood, SC 29646-2757
Phone (864) 229-4446

355 Cambridge Ave W
Greenwood, SC 29646-2191
Phone (864) 396-5268

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21167SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Health Centers, Inc. Family Medicine Current Accepting new patients
Carolina Health Centers, Inc. CurrentSince Nov 22, 2008 Accepting new patients
Carolina Health Centers, Inc. Family Medicine CurrentSince Nov 22, 2008 Accepting new patients
Hospital Consultants of Greenwood Family Medicine CurrentSince Feb 28, 2013 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Carolina Health Centers, Inc. Family Medicine Past Accepting new patients
Carolina Health Centers, Inc. Family Medicine PastSince Nov 22, 2008 Accepting new patients

Locations

313 Main St
#A
Greenwood, SC 29646
Phone (864) 229-4446

313 Main St
#B
Greenwood, SC 29646

313 Main St
Ste A
Greenwood, SC 29646
Phone (864) 229-4446

313 Main St
Ste B
Greenwood, SC 29646
Phone (864) 229-4446

355 Cambridge Ave W
Greenwood, SC 29646
Phone (864) 229-1715

420 Epting Ave
#B
Greenwood, SC 29646
Phone (864) 388-0301

Interoperability endpoints

  • Direct secure messaging: jdahlberg272292@direct.ochin.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1508800848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MAIN ST",
            "address_2": "SUITE B",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462757",
            "telephone_number": "864-388-0301",
            "fax_number": "864-388-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MAIN ST",
            "address_2": "SUITE A",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462757",
            "telephone_number": "864-229-4446",
            "fax_number": "864-229-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLBERG",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.