Active NPI
Kishan Vinesh Kumar, MD
- Pediatrics Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 89147
- Practice address
- 4605 Monticello Rd Ste 1
Columbia, SC 29203-4156 - Phone
- (803) 252-7001
- Fax
- (803) 252-5219
- NPI assigned
- Apr 6, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 89147 | SC | Primary |
Addresses
Primary practice location
4605 Monticello Rd Ste 1
Columbia, SC 29203-4156
Mailing address
4605 Monticello Rd Ste 1
Columbia, SC 29203-4156
Phone (803) 252-7001
Other practice location 1
1000 Whaley St Apt 1094
Columbia, SC 29201-4278
Phone (525) 608-7473
Other practice location 2
121 Dekalb Ave
Brooklyn, NY 11201-5493
Phone (718) 250-6857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eau Claire Cooperative Health Center, Inc. | Pediatrics | Current | Accepting new patients |
| Eau Claire Cooperative Health Center ,Inc. | Current | Accepting new patients | |
| Pratt Urology Associates, Inc | Past | Accepting new patients | |
| Pediatrics of Newberry, LLC | Pediatrics | Past | Accepting new patients |
Locations
169 Laurelhurst Ave
Columbia, SC 29210
Phone (803) 730-0742
4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001
4605 Monticello Rd
Ste 1
Columbia, SC 29203
Phone (803) 252-7001
Interoperability endpoints
- kkumar11133@prd.direct.tbh.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.
-
- Federally Qualified Health Center (FQHC)
- Columbia, SC
- NPI 1346249430
Pediatrics
-
- Federally Qualified Health Center (FQHC)
- Columbia, SC
- NPI 1588375653
-
- Pediatrics Physician
- Newberry, SC
- NPI 1659400851
-
- Urology Physician
- Boston, MA
- NPI 1497795025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1639676679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4605 MONTICELLO RD STE 1",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292034156",
"telephone_number": "803-252-7001",
"fax_number": "803-252-5219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MONTICELLO RD STE 1",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292034156",
"telephone_number": "803-252-7001",
"fax_number": "803-252-5219"
}
],
"practiceLocations": [
{
"address_1": "1000 Whaley St Apt 1094",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292014278",
"country_code": "US",
"telephone_number": "525-608-7473",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "121 Dekalb Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112015493",
"country_code": "US",
"telephone_number": "718-250-6857",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUMAR",
"first_name": "KISHAN",
"middle_name": "VINESH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-06",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "89147",
"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 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.