Active NPI
Janet L Kubas, NP
- Acute Care Nurse Practitioner
- Columbia, SC
National Provider Identifier
1679575559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 2518
- Practice address
- 114 Gateway Corporate Blvd Ste 420
Columbia, SC 29203-9785 - Phone
- (803) 365-8650
- Fax
- (803) 365-8659
- NPI assigned
- Aug 11, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2518 | SC | Primary |
Addresses
Primary practice location
114 Gateway Corporate Blvd Ste 420
Columbia, SC 29203-9785
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7878
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2518 | Other | SC | SC LICENSE |
| NP0903 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2518 | SC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1679575559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275098",
"telephone_number": "615-920-7878",
"fax_number": "615-920-8775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 GATEWAY CORPORATE BLVD STE 420",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292039785",
"telephone_number": "803-365-8650",
"fax_number": "803-365-8659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBAS",
"first_name": "JANET",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "SC",
"license": "2518",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC LICENSE",
"identifier": "2518",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0903",
"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 Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.