Stephanie Phillips Ambrose, DO
Individual provider Active NPI Pediatric Hematology & Oncology Physician · Columbia, SC
NPI 1639466360 · NPPES record last updated Nov 15, 2022
Key facts
- NPI
- 1639466360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Hematology & Oncology Physician 2080P0207X
- License
- 1502 (SC)
- Practice address
- 7 Richland Medical Park Dr Ste 7215
Columbia, SC 29203-6863 - Phone
- (803) 434-3533
- Fax
- (803) 434-3094
- NPI assigned
- Jul 1, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prisma Health Medical Group-Midlands
Practice addresses (Care Compare)
7 Richland Medical Park Dr
Suite 203
Columbia, SC 29203-6863
Phone (803) 545-5017
Hospital & facility affiliations
- Prisma Health Richland Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171219002835 | SC | Practitioner - Pediatric Medicine |
6608097274 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1502 | SC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health Medical Group-Midlands | Pediatrics | Current |
Accepting new patients |
| Prisma Health Medical Group-Midlands | Current |
Accepting new patients |
Locations
7 Richland Medical Park Dr
Ste 7215
Columbia, SC 29203
Phone (803) 434-3533
100 Palmetto Health Pkwy
Ste 104
Columbia, SC 29212
Phone (803) 434-5668
7 Richland Medical Park Dr
Ste 203
Columbia, SC 29203
Phone (803) 434-3533
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
101 William H Johnson St
Ste 400
Florence, SC 29506
Phone (803) 434-7961
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
Interoperability endpoints
- sambrose376463@direct.ghs.myhfn.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1502 | SC | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 1502 | SC | Yes |
Addresses
Primary practice location
7 Richland Medical Park Dr Ste 7215
Columbia, SC 29203-6863
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015021 | Medicaid | SC |
Other providers in Columbia, SC
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- Uma M Amarnath
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- Amber'S Hope, LLC
- Ambition Home Care LLC
- Jaroslaw M Ambroziak
- Ameliorating Harmony Massage LLC
- America'S Best Contacts & Eyeglasses
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- American Allied Health
All providers in Columbia, SC · Pediatric Hematology & Oncology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.