NPIMap

Organization Active NPI

Midlands Neurology & Pain Assoc, P.a

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Columbia, SC
National Provider Identifier
1699280644
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
18323 Issued in SC
Legal business name
MIDLANDS NEUROLOGY & PAIN ASSOC, P.A
Practice address
2601 Millwood Ave
Columbia, SC 29205-1218
Phone
(803) 788-0038
NPI assigned
Dec 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Authorized official

Name
Eleanya Ogburu-Ogbonnaya, MDNPI 1104005941
Title
President Ceo
Phone
(803) 788-0038

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084A0401X 18323 SC Primary
Substance Abuse Rehabilitation Facility 324500000X 18323 SC

Addresses

Primary practice location

2601 Millwood Ave
Columbia, SC 29205-1218

Mailing address

PO Box 209
State Park, SC 29147-0209

Other identifiers 1

IdentifierTypeStateIssuer
GP1403MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Midlands Neurology Pain2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1699280644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "STATE PARK",
            "state": "SC",
            "postal_code": "291470209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 MILLWOOD AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051218",
            "telephone_number": "803-788-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLANDS NEUROLOGY & PAIN ASSOC, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "OGBURU-OGBONNAYA",
        "authorized_official_first_name": "ELEANYA",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "803-788-0038",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "SC",
            "license": "18323",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "SC",
            "license": "18323",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1403",
            "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 Dec 13, 2017; 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.