Thaddeus Paul Ozimek, M.D.

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

MD026757E Issued in PA

Practice address

4500 Stuart Street
Moncrief Army Community Hospital
Fort Jackson, SC 29207-5720

Phone

(803) 751-2157

Fax

(803) 751-2650

NPI assigned

Oct 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598854507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HUNTERS POND DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299011",
            "telephone_number": "803-699-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 STUART STREET",
            "address_2": "MONCRIEF ARMY COMMUNITY HOSPITAL",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2157",
            "fax_number": "803-751-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZIMEK",
        "first_name": "THADDEUS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "PA",
            "license": "MD026757E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD026757E",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moncrief Army Community Hospital (Usadc Hagen-Jackson)
• Moncrief Army Community Hospital (Usadc Phy Exam Sta-Jackson)
• National Vision, Inc.
• Renee Lucille Nelson, RN
• Mary Anne Oliver, APRN-BC, FNP
• Mandy Shealey Poston, PHARMD.
• Angela Robinson, CRNA
• Todd Michael Rowe, PA
• Stefan Sherman, DDS
• Emily Grace Slusher

• Psychiatric Hospital Unit in Fort Jackson, SC
• Providers in Fort Jackson, SC by specialty
• Psychiatric Hospital Unit in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.