NPIMap

Organization Active NPI

University Specialty Clinics - Surgery

  • Surgery Physician
  • Columbia, SC
National Provider Identifier
1508898958
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
UNIVERSITY SPECIALTY CLINICS - SURGERY
Practice address
Two Medical Park
Suite300
Columbia, SC 29203-6839
Phone
(803) 256-2657
Fax
(803) 434-1581
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
William D. Anderson III, MD
Title
Cmo
Phone
(803) 256-2657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

Two Medical Park
Suite300
Columbia, SC 29203-6839

Mailing address

15 Medical Park
Suite 300
Columbia, SC 29203-6843
Phone (803) 545-5022

Other identifiers 1

IdentifierTypeStateIssuer
PA2960MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1508898958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036843",
            "telephone_number": "803-545-5022",
            "fax_number": "803-256-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TWO MEDICAL PARK",
            "address_2": "SUITE300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036839",
            "telephone_number": "803-256-2657",
            "fax_number": "803-434-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SPECIALTY CLINICS - SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "803-256-2657",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA2960",
            "state": "SC"
        }
    ],
    "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 Dec 3, 2014; 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.