NPIMap

Organization Active NPI

University Specialty Clinics - Neuropsychiatry and Behavioral Science

  • Psychologist
  • Columbia, SC
National Provider Identifier
1699703306
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
UNIVERSITY SPECIALTY CLINICS - NEUROPSYCHIATRY AND BEHAVIORAL SCIENCE
Practice address
15 Medical Park
Suite 301
Columbia, SC 29203-6843
Phone
(803) 434-4250
Fax
(803) 434-4277
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Dr. William D. Anderson III, MD
Title
Cmo
Phone
(803) 434-4250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

15 Medical Park
Suite 301
Columbia, SC 29203-6843

Mailing address

15 Medical Park
Suite 300
Columbia, SC 29203-6843
Phone (803) 545-5022

Other identifiers 1

IdentifierTypeStateIssuer
GP0720MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
University Specialty Clinics - Neuropsychiatry and Behavioral Science2 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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1699703306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036843",
            "telephone_number": "803-545-5022",
            "fax_number": "803-256-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 301",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036843",
            "telephone_number": "803-434-4250",
            "fax_number": "803-434-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SPECIALTY CLINICS - NEUROPSYCHIATRY AND BEHAVIORAL SCIENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "803-434-4250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0720",
            "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 11, 2014; 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.