NPIMap

Individual provider Active NPI

Samuel Curtis Elliott III, M.D.

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1629299359
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12460 Issued in SC
Practice address
3209 Colonial Dr
Columbia, SC 29203-6930
Phone
(803) 434-6113
Fax
(803) 580-1067
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12460 SC Primary

Addresses

Primary practice location

3209 Colonial Dr
Columbia, SC 29203-6930

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 2

IdentifierTypeStateIssuer
124608MedicaidSC
AA88822353OtherSCMEDICARE PTAN-

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address selliott378952@direct.ghs.myhfn.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000008 SC Practitioner - Family Practice 0840390647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 1984
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)

3209 Colonial Dr
Columbia, SC 29203-6930
Phone (803) 434-6113

Hospital & facility affiliations

  • Prisma Health Homecare Home health agency, Columbia, SC, CCN 427013
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12460SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Jul 2, 2017 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jul 2, 2017 Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Locations

2 Medical Park Rd
Ste 203
Columbia, SC 29203
Phone (803) 212-7130

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

3209 Colonial Dr
Columbia, SC 29203
Phone (803) 434-6113

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

Interoperability endpoints

  • Direct secure messaging: selliott378952@direct.ghs.myhfn.org

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.

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1629299359",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036930",
            "telephone_number": "803-434-6113",
            "fax_number": "803-580-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SAMUEL",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "12460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124608",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN-",
            "identifier": "AA88822353",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selliott378952@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "selliott378952@direct.ghs.myhfn.org",
            "address_1": "3209 Colonial Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292036930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.