Active NPI
Charles Driggers
- Physician Assistant
- Columbia, SC
National Provider Identifier
1588086672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2047
- Practice address
- 120 Gateway Corporate Blvd
Columbia, SC 29203-9611 - Phone
- (803) 865-4500
- NPI assigned
- Jan 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2047 | SC | Primary |
Addresses
Primary practice location
120 Gateway Corporate Blvd
Columbia, SC 29203-9611
Mailing address
3333 Dreher Shoals Rd
Irmo, SC 29063-9348
Phone (954) 806-4374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2047 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1588086672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 DREHER SHOALS RD",
"city": "IRMO",
"state": "SC",
"postal_code": "290639348",
"telephone_number": "954-806-4374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 GATEWAY CORPORATE BLVD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292039611",
"telephone_number": "803-865-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRIGGERS",
"first_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-09",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "2047",
"primary": true
}
],
"identifiers": [],
"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 Jan 9, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.