NPIMap

Individual provider Active NPI

William Matthew Wooten, D.O.

  • Infectious Disease Physician
  • Columbia, SC
National Provider Identifier
1548604341
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
83522 Issued in SC
Practice address
1 Richland Medical Park Dr Ste 420
Columbia, SC 29203-6833
Phone
(803) 434-6430
Fax
(803) 545-5353
NPI assigned
Apr 23, 2013
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2019-00825 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 83522 SC
Infectious Disease Physician 207RI0200X 83522 SC Primary

Addresses

Primary practice location

1 Richland Medical Park Dr Ste 420
Columbia, SC 29203-6833

Mailing address

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

Other practice location 1

2400 Stantonsburg Rd
Greenville, NC 27834-7210
Phone (252) 847-7924

Other practice location 2

7350 Industrial Park Blvd
Mentor, OH 44060-5318
Phone (216) 732-9480

Other identifiers 1

IdentifierTypeStateIssuer
835225MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191231000425 NC Practitioner - Internal Medicine 1052533072 Reassigns benefits to 1 organization
I20210827002675 SC Practitioner - Infectious Disease 1052533072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Ohio University, College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1 Richland Medical Park Dr
Suite 420
Columbia, SC 29203-6833
Phone (803) 545-5350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 1, 2019 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 1, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Aug 2, 2021 Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1 Richland Medical Park Dr
Ste 420
Columbia, SC 29203
Phone (803) 434-6430

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

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

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

Interoperability endpoints

  • Direct secure messaging: wwooten513486@direct.ghs.myhfn.org

Organizations & group practices 6

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 11

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1548604341",
    "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": "803-296-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHLAND MEDICAL PARK DR STE 420",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036833",
            "telephone_number": "803-434-6430",
            "fax_number": "803-545-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278347210",
            "country_code": "US",
            "telephone_number": "252-847-7924",
            "fax_number": "252-847-4616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7350 Industrial Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440605318",
            "country_code": "US",
            "telephone_number": "216-732-9480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "WILLIAM",
        "middle_name": "MATTHEW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-00825",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "83522",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "83522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835225",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.