Organization Active NPI

Sandhills Rheumatology, LLC

  • Rheumatology Physician
  • Columbia, SC
National Provider Identifier
1649526997
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
28893 Issued in SC
Legal business name
SANDHILLS RHEUMATOLOGY, LLC
Practice address
2233 Clemson Rd
Columbia, SC 29229-8016
Phone
(803) 462-2884
Fax
(803) 462-2883
NPI assigned
Jul 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Dr. Suneetha K Morthala, M.D.NPI 1407880941
Title
Owner
Phone
(803) 462-2884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 28893 SC Primary

Addresses

Primary practice location

2233 Clemson Rd
Columbia, SC 29229-8016

Mailing address

4611 Hard Scrabble Rd
Suite 359
Columbia, SC 29229-8584
Phone (803) 462-2884

Other identifiers 1

IdentifierTypeStateIssuer
288931MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121204000052 SC Part B Supplier - Clinic/Group Practice 3072765783 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

2233 Clemson Rd
Columbia, SC 29229
Phone (803) 462-2824

4611 Hard Scrabble Rd
Ste 359
Columbia, SC 29229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1649526997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 HARD SCRABBLE RD",
            "address_2": "SUITE 359",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298584",
            "telephone_number": "803-462-2884",
            "fax_number": "803-462-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298016",
            "telephone_number": "803-462-2884",
            "fax_number": "803-462-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDHILLS RHEUMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "MORTHALA",
        "authorized_official_first_name": "SUNEETHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-462-2884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "SC",
            "license": "28893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288931",
            "state": "SC"
        }
    ],
    "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 Jun 28, 2013; 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.

Verify at the official NPI Registry.