Individual provider Active NPI

Dedrick A Hilton

  • Home Modifications Contractor
  • Columbia, SC
National Provider Identifier
1669209060
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
Practice address
400 Greenlawn Dr Apt K3
Columbia, SC 29209-2527
Phone
(803) 200-2231
NPI assigned
Sep 18, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X SC Primary

Addresses

Primary practice location

400 Greenlawn Dr Apt K3
Columbia, SC 29209-2527

Mailing address

400 Greenlawn Dr Apt K3
Columbia, SC 29209-2527
Phone (803) 200-2231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1669209060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GREENLAWN DR APT K3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092527",
            "telephone_number": "803-200-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GREENLAWN DR APT K3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092527",
            "telephone_number": "803-200-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILTON",
        "first_name": "DEDRICK",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "SC",
            "license": null,
            "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 Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.