Individual provider Active NPI

David Timothy Powell, M.D.

  • Neuroradiology Physician
  • Greenville, SC
National Provider Identifier
1639499197
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
38608 Issued in SC
Practice address
1210 W Faris Rd
Greenville, SC 29605-4444
Phone
(864) 522-1800
Fax
(864) 522-1806
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 38608 SC
Neuroradiology Physician 2085N0700X 38608 SC Primary

Addresses

Primary practice location

1210 W Faris Rd
Greenville, SC 29605-4444

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other practice location 1

1519 Marion St
Columbia, SC 29201-2910
Phone (803) 296-5954

Other identifiers 1

IdentifierTypeStateIssuer
386086MedicaidSC

Other names 1

  • Timothy Powell Other name

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831002732 SC Practitioner - Diagnostic Radiology 6901044692 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38608SCMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Feb 27, 2021 Accepting new patients

Locations

5 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-2168

1519 Marion St
Columbia, SC 29201
Phone (803) 296-5513

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

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1639499197",
    "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": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054444",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 Marion St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012910",
            "country_code": "US",
            "telephone_number": "803-296-5954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DAVID",
        "middle_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "38608",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "SC",
            "license": "38608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386086",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "POWELL",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.