Individual provider Active NPI

William S Stavrou, MD

  • Cardiovascular Disease Physician
  • Sumter, SC
National Provider Identifier
1528031531
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
7862 Issued in SC
Practice address
115 N Sumter St Ste 410
Sumter, SC 29150-4969
Phone
(803) 774-9797
Fax
(803) 774-9796
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 7862 SC Primary

Addresses

Primary practice location

115 N Sumter St Ste 410
Sumter, SC 29150-4969

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
078622MedicaidSC

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
I20100216000931 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7719021666 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7862SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Tuomey Cardiovascular Disease CurrentSince Nov 29, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 2, 2018 Accepting new patients
Prisma Health Tuomey CurrentSince Nov 29, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 2, 2018 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

8 Richland Medical Park Dr
Ste 100
Columbia, SC 29203

115 N Sumter St
Ste 410
Sumter, SC 29150
Phone (803) 774-9797

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • Direct secure messaging: william.stavrou.1@7602.direct.athenahealth.com

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1528031531",
    "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": "115 N SUMTER ST STE 410",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504969",
            "telephone_number": "803-774-9797",
            "fax_number": "803-774-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVROU",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "7862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078622",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.