Individual provider Active NPI

Michael Alan Kanwisher, MD

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1689969453
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33542 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone
(803) 434-1663
Fax
(803) 434-3894
NPI assigned
Jun 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33542 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
335426MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314000920 SC Practitioner - Emergency Medicine 9436455748 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33542SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Midlands Current Accepting new patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Jun 7, 2025 Accepting new patients
McLeod Health Cheraw CurrentSince Feb 2, 2016 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 1, 2021 Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Feb 2, 2016 Accepting new patients
Edcare Consulting LLC Emergency Medicine CurrentSince Feb 11, 2022 Accepting new patients
Prisma Health Medical Group-Midlands Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Prisma Health-Midlands CurrentSince Oct 2, 2016 Accepting new patients

Locations

420 Thomson Cir
Abbeville, SC 29620
Phone (864) 366-1649

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

1330 Taylor St
Ste 100
Columbia, SC 29201
Phone (803) 434-6410

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

400 Palmetto Health Pkwy
Columbia, SC 29212
Phone (803) 296-5579

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

1524 Barnwell Hwy
Denmark, SC 29042
Phone (803) 395-3352

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Interoperability endpoints

  • Direct secure messaging: mkanwisher413064@direct.ghs.myhfn.org
  • Direct secure messaging: mkanwisher25533@directmcleodehealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1689969453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANWISHER",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "33542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335426",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.