Department of Internal Medicine

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4273 Issued in SC

Legal business name

DEPARTMENT OF INTERNAL MEDICINE

Practice address

1 Richland Medical Park Dr
Suite 420
Columbia, SC 29203-6834

Phone

(803) 545-5350

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Nancy Raley

Title

Director

Phone

(803) 545-5354

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1679886881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 420",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 420",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036834",
            "telephone_number": "803-545-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-545-5354"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.