Haley Tiedemann, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

6264 Issued in SC

Practice address

14 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6883

Phone

(803) 434-8450

Fax

(803) 434-0137

NPI assigned

Feb 26, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1568317329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 310",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036883",
            "telephone_number": "803-434-8450",
            "fax_number": "803-434-0137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 College Ave",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "VA",
            "postal_code": "23005",
            "country_code": "US",
            "telephone_number": "804-752-8878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEDEMANN",
        "first_name": "HALEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "6264",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "6264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tia Cares for Me Home Health Agency LLC
• Madison Tiago, RBT
• Kristen Anne Tice, MS, RD, LD
• Michael David Tichenor, MD
• Taylor Paul Tidwell, MD
• Stephanie Elizabeth Tighe
• Erika Elizabeth Tillery, PHARM.D.
• Edward Allen Tillitz II, D.O.
• Jessica Lynn Tillman, PHD, MPH, RN
• Suzanne M Tillman, RN

• Surgical Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Surgical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.